足月新生儿窒息对肾功能的影响  

Effect of aspHyxia at birth on kidney function of full-term newborns

作　　者：朱慧[1] 

机构地区：[1]福建医科大学省立临床学院福建省立医院重症新生儿科,福州350001

出　　处：《临床肾脏病杂志》2016年第1期44-47,共4页Journal Of Clinical Nephrology

摘　　要：目的探讨窒息缺氧后对足月儿肾功能的影响。方法选择福建省立医院重症新生儿科收治的足月窒息新生儿121例,根据患儿窒息程度分为重度窒息组30例和轻度窒息组91例;同时选择正常足月新生儿100例作为健康对照组。采用肌氨酸氧化酶法测定其血肌酐(SCr)水平并记录患儿24h尿量,根据急性肾损伤的诊断标准:SCr≥健康新生儿均值50%以上(即SCr>60μmol/L),或尿量<0.5 ml·kg^(-1)·h^(-1)达6h以上来评估肾功能。根据脐动脉血气分析,将重度窒息患儿进一步分为合并严重酸中毒组和无严重酸中毒组。比较窒息足月儿(包括轻度窒息组和重度窒息组)与健康对照组急性肾损伤的发生率;比较重度窒息合并严重酸中毒组与重度窒息无严重酸中毒组的急性肾损伤发生率。结果轻度窒息组、重度窒息组、健康对照组、重度窒息合并严重酸中毒组和重度窒息无严重酸中毒组急性肾损伤的发生率分别为38.5%(35/91),80.0%(24/30),1.0%(1/100),100%(13/13),64.7%(11/17)。轻度窒息组与重度窒息组急性肾损伤发生率进行比较差异有统计学意义(P<0.05);轻度窒息组急性肾损伤发生率明显高于健康对照组(P<0.05);重度窒息组急性肾损伤发生率明显高于健康对照组(P<0.05);提示窒息程度越重,肾功能受损发生率越高,受损程度越严重。重度窒息合并酸中毒组急性肾损伤的比例明显高于重度窒息无严重酸中毒组(P<0.05)。预后不良9例,其中死亡3例,因病重放弃治疗6例,预后不良率为15.3%。结论足月新生儿窒息会导致肾功能损害。结合脐动脉血气分析判断窒息严重程度,合并严重酸中毒的患儿急性肾损伤发生率更高。应尽早认识急性肾损伤,及早诊断和治疗,降低病死率。Objective To find out the effects of aspHyxia on kidney function of full-term borns. Methods One hundred and twenty-one cases of full-term newborns with aspHyxia at birth, were divided into 2 groups： severe asphyxia group （30 cases）, mild aspHyxia group （91 cases）. 100 normal full-term neonates were selected during the same period as control group. All their serum creatinine （SCr） was measured by using sarcosine oxidase method. And the urine volume of 24 hours was coun- ted. According to the diagnostic criteria of acute kidney injury： SCr≥60 gmol/L or urine volume 〈0. 5 ml·kg^-1·h^-1 lasting more than 6 hours, we assessed kidney function. According to the umbili- cal arterial blood gas analysis, severe asphyxia was divided into two groups：the severe aspHyxia with severe acidosis group and the severe aspHyxia without acidosis group. Then the rates of acute kidney injury were compared in pairs between mild asphyxia group, severe asphyxia group and normal full- term neonates group. The rates of acute kidney injury were compared between asphyxia group （inclu- ding mild aspHyxia group and severe asphyxia group） and normal full-term neonates group. Then the rates of acute kidney injury were compared in pairs betweenthe severe asphyxia with severe acidosis group and the severe aspHyxia without acidosis group. Results Therates of acute kidney injury in mild aspHyxia group,severe aspHyxia group, normal full-term neonates group, the severe aspHyxia with severe acidosis group and the severe aspHyxia without acidosis group were respectively 38. 5% （35/91）, 80. 0%（24/30）, 1.0%（1/100）, 100% （13/13）, 64. 7% （11/17）. There were significant differences of the rates of acute kidney injury between mild aspHyxia group and severe aspHyxia group （P〈0. 05）. The rates of acute kidney injury in mild aspHyxia group were statistically significantly high- er than those in control group （P〈0. 05）. The rates of acute kidney injury in severe asphyxia group were statistically significa

关 键 词：足月新生儿 窒息 急性肾损伤 

分 类 号：R722.1[医药卫生—儿科]