高胆红素血症足月新生儿血清胱抑素C及尿β_2-微球蛋白水平变化及临床意义  

The Changes and Its Clinical Significance of Serum Cystatin C and Urinaryβ_2-Microglobulin Levels in Full-Term Neonates With Hyperbilirubinemia

作　　者：徐玉华[1] 赵智勇[2] 段玉龙[2] 

机构地区：[1]四川省广元市中心医院检验科,四川广元628000 [2]四川省广元市中心医院儿科,四川广元628000

出　　处：《中华妇幼临床医学杂志（电子版）》2013年第6期691-694,共4页Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition)

摘　　要：目的 观察高胆红素血症足月新生儿血清胱抑素C（CysC）及尿β2-微球蛋白（β2-MG）水平变化,探讨高胆红素血症对足月新生儿肾功能的影响.方法 选择2011年6月至2013年6月广元市中心医院新生儿科住院的患高胆红素血症的足月新生儿70例为研究对象（为高胆红素血症组）.再将其按照血清胆红素（TBIL）水平值进一步分为：轻度亚组（n=32）,血清TBIL为（220.6～342.0）μmol/L;重度亚组（n=38）,TBIL＞342.0 μmol/L.按照入院顺序号随机选取同期广元市中心医院分娩的正常足月新生儿（血清未结合胆红素＜85.5 μmol/L）为对照组（n=30）（本研究遵循的程序符合广元市中心医院人体试验委员会制定的伦理学标准,得到该委员会批准,征得受试对象监护人知情同意,并与监护人签署临床研究知情同意书）.高胆红素血症组及对照组均排除先天畸形、感染及窒息等新生儿.高胆红素血症组与对照组新生儿性别、孕龄、分娩方式、Apgar评分、出生体重及日龄等比较,差异无统计学意义（P〉0.05）.采用全自动生化仪测定血清CysC含量;采用化学发光免疫分析法测定尿β2-MG含量.采用SPSS13.0统计学软件包进行统计学处理.结果重度亚组新生儿血清CysC、尿β2-MG平均值显著高于轻度亚组新生儿,差异有统计学意义（P〈0.01）;轻度亚组血清CysC、尿β2-MG与对照组平均值比较,差异无统计学意义（P〉0.05）;重度亚组血清CysC、尿β2-MG与对照组平均值比较,差异有统计学意义（P〈0.01）;轻度亚组新生儿治疗前后血清CysC、尿β2-MG比较,差异无统计学意义（P〉0.05）;重度亚组新生儿治疗前后血清CysC、尿β2-MG比较,差异有统计学意义（P〈0.01）.高胆红素血症新生儿血清TBIL与血清CysC、尿β2-MG存在正相关性,血清CysC与尿β2-MG亦存在正相关性.结论 在患高胆红素血症的足月新生儿中,重度高胆红素血症可造成新�Objective Investigate the changes of levels of serum cystatin C （CysC） and urinary β2-Microglobutin （β2-MG） in full-term neonates with hyperbilirubinemia. To explore the effect of hyperbilirubinemia on renal function in full-term neonates with hyperbilirubinemia. Methods A total of 70 full-term neonates with hyperbilirubinemia from June 2011 to June 2013 in our hospital were divided into two sub-groups., mild sub-group （n = 32） with serum bilirubin levels （ 220.6 ± 342.0） μmol/L and severe sub- group （n=38） with serum bilirubin levels more than 342.0 μmol/L. 30 healthy full-term neonates with serum bilirubin levels less than 85.5 μmol/L were recruited as control group. The general clinical data had no significant difference （P〉 0.05）. The study protocol was approved by the Ethical Review Board of Investigation in Human Beings of Central Hospital of Guangyuan. Informed consent was obtained from the parents of each participating patient. CysC were determined by processing Biology and Chemistry, β2-MG were determined by chemiluminescence immunoassay（CLIA）. SPSS 13.0 software was used to analyze the data. Results Levels of serum CysC and urinaryβ2-MG in the severe hyperbilirubinemia group were obviously higher than that in the mild group（P〈0.01）. There had no significant difference of serum CysC and urinary β2-MG between mild hyperbilirubinemia full-term neonates group and control group（P〈0.05）,but those in severe hyperbilirubinemia group were significantly higher （P 〈 0.01 ）. CysC and β2-MG decreased significantly after therapy in severe hyperbilirubinemia （P〈0.01）, but there had no significant difference after therapy in mild hyperbilirubinemia （P）0.05）. By linear correlation analysis, there had positive correlations between the levels of the serum CysC and urinary β2-MG, serum CysC and serum bilirubin, urinary β2-MG and serum bilirubin. Conclusions Severe hyperbilirubinemia can induce renal damage in neonates. Serum CysC and urinary β2-MG can

关 键 词：新生儿高胆红素血症 胱抑素C Β2-微球蛋白 新生儿 

分 类 号：R722.1[医药卫生—儿科]