血胱抑素C检测对围产期新生儿高胆红素血症肾脏损害的评估价值  

The investigate value of Cystain C study in hyperbilirubinemia renal damage of newborn in perinatal period

作　　者：郑杰[1] 王庆法[1] 李继军[1] 刘国志[1] 魏守刚[1] 

机构地区：[1]潍坊医学院附属益都中心医院,262500

出　　处：《中国优生与遗传杂志》2012年第4期92-94,共3页Chinese Journal of Birth Health & Heredity

摘　　要：目的探讨围产期新生儿高胆红素血症血胆红素、血胱抑素C的变化及其对肾脏损害的评估价值。方法选择2009年10月-2010年10月在本院住院的新生儿高胆红素血症患儿44例为观察组,按黄疸程度分为轻度黄疸,220-265μmol/L,中度黄疸265-342μmol/L,重度黄疸≥342μmol/L,对照组为同期在本科住院的无新生儿高胆红素血症的新生儿40例,所有患儿在入院当天抽股静脉血3毫升,查肝功、肌酐、尿素氮、β2微球蛋白及胱抑素C,黄疸消退后复查血胆红素及胱抑素C,并做统计学处理。结果轻度组21例,中重度组23例,对照组40例,观察组与对照组在总胆红素及间接胆红素数值有显著性差异(P<0.01);观察组与对照组肌酐、尿素氮无显著性差异(P>0.05);观察组胱抑素C、β2微球蛋白显著高于对照组(P<0.01,P<0.05),提示黄疸程度越重,血胱抑素C及β2微球蛋白值越高,肾脏损害越重,经治疗后,观察组总胆红素、胱抑素C及β2微球蛋白水平明显下降,与治疗前比较有显著性差异(P<0.01,P<0.05),观察组治疗后血胱抑素C显著下降,与对照组比较无显著性差异(P>0.05),观察组血胱抑素C、β2微球蛋白、尿素氮与总胆红素值之间的关系:血清CysC、β2-MG与TBil值呈正相关(r分别为0.71、0.42,P均<0.01);尿素氮、肌酐与总胆红素值之间无相关性(r=0.24,P>0.05)。结论新生儿高胆红素血症可造成肾脏损害,围产儿尤其明显,但它对肾脏损害是暂时的,可逆的,通过对新生儿高胆红素血症的患儿检测血胱抑素C,可以早期发现肾损害,避免使用肾损伤药物,及早进行干预,提高本病的治愈率。Objective： To study the change of hemobilirubin and Cystatin C of hyperbilirubinemia and the investigate value of renal damage.Methods：44 newborns with hyperbilirubinemia were collected in our hospital from October 2009 to October 2010,which were observational members.The ICT is classified as low-grade ICT,220~265μmol/L,middle-grade ICT,265~342μmol/L,high-grade,greater than 342 μmol/L.The contrapositive group includes 40 members without hyperbilirubinemia in our hospital at the same period.All the newborns were exsanguinate 3ml blood from femural vein,tested hepatic function,creatinine,BUN,β2-MG and Cystain C.Test hemobilirubin and Cystain C again when the ICT was fadeaway and deal with statistic methods.Results：There are 21 newborns in low-grade,23 newborns in high-grade,40 newborns in constrapositive group.The figure about total bilirubin and indirect bilirubin has great difference between observational group and contrapositive group（P0.01）.There is no significant difference between two groups（P0.05）.The Cystatin C and β2-MG of observational group are much higher than contrapositive group.（P0.01,P0.05）,which indicates the more serioud the ICT is,the bigger the figure of Cystatin C and β2-MG is,the bigger the renal damage is.The level of total bilirubin,Cystatin C,β2-MG of observational group drops sharply after being treated.The Cystatin C′s dropping level after being treated between observational group and contrapositive group is same（P0.05）.The serous Cystatin C,β2-MG has positively relation with TBil.（r=0.71,0.42,P0.01）.The figure of BUN,Cr has no relation with TBil.（r=0.24,P0.05） Conclusions： The newborn hyperbilirubinemia maybe bad for kidney,especially the perinatal period newborn.But the damage is reversible and temporal.According to test hemocystain C of newborns with hyperbilirubin,we can find out the kidney injury earlier,prevent using kidney damage drugs and intervene earlier,improve the cure rate.

关 键 词：新生儿 高胆红素血症 肾脏损害 血胱抑素C 

分 类 号：R722.1[医药卫生—儿科]