高未结合胆红素血症新生儿血和尿胱抑素C水平变化分析  

Analysis of serum and urine cystatin C level in neonates with unconjugated hyperbilirubinemia

作　　者：欧阳向东[1] 彭华保[1] 邝晓敏 谭若锟[1] 曾群[1] 朱军民[1] 

机构地区：[1]南华大学附属郴州市第一人民医院新生儿科,423000

出　　处：《中国新生儿科杂志》2016年第3期168-172,共5页Chinese Journal of Neonatology

基　　金：郴州市科技局科学技术项目(CZ2014028)

摘　　要：目的动态观察高未结合胆红素血症新生儿血清胱抑素C（Cys C）及尿Cys C水平变化,探讨高未结合胆红素血症对新生儿肾功能的影响。方法选取2013年6月至2014年6月入住我院新生儿科的高未结合胆红素血症新生儿为观察组,根据入院第1天总胆红素（TBil）水平分为轻度组（221～255μmol/L）、中度组（256～341μmol/L）及重度组（≥342μmol/L）;选取我院产科分娩的健康足月儿为对照组。观察组于入院第1、4、7天检测血、尿Cys C水平,对照组于入院第1天检测上述指标,并进行组间及组内比较。结果观察组共纳入58例,其中轻度组15例,中度组21例,重度组22例;对照组入选20名。入院第1天中度组尿Cys C水平高于对照组（P〈0.05）,重度组血、尿Cys C水平高于轻、中度组及对照组（P〈0.05）,其余各组间比较差异均无统计学意义（P〉0.05）;入院第1天,血、尿Cys C水平与血清TBil值成正相关（P〈0.05）。中度组尿Cys C水平随时间变化呈下降趋势,重度组血、尿Cys C水平均随时间变化呈下降趋势。结论中、重度高未结合胆红素血症新生儿可合并肾功能损伤,经积极治疗后,肾功能逐渐恢复。血、尿Cys C水平对评价新生儿早期肾功能损伤有重要临床意义。Objective To study the effects of unconjugated hyperbilirubinemia on the renal function of newborns by dynamic observations on the changes of serum and urine cystatin C（ Cys C）.Methods A total of 58 term infants with unconjugated hyperbilirubinemia admitted to the No. 1 People＇s Hospital of Chenzhou city,affiliated to Nanhua Univerisity from June 2013 to June 2014 were recruited as the observation group. All the 58 newborns were assigned to three groups according to the total serum bilirubin levels（ TBil） on the first day of hospitalization, mild group（ 221 μmol / L ≤ TBil 〈256 μmol / L,15 cases）,moderate group（ 256 μmol / L≤TBil 342 μmol / L,21 cases） and severe group（ TBil ≥ 342 μmol / L,22 cases）. 20 clinically well newborns who were born in the Obstetric Department of our Hospital were recruited as controls. Serum and urine Cys C levels were tested on the first,fourth and seventh day of hospitalization in the observation group,while only the first day of hospitalization in the control group. The results were then compared among groups. Results Urine Cys C level in the moderate group which was tested on the first day of hospitalization was significantly higher than that of control group（ P〈0. 05）. Serum and urine Cys C levels of the severe group were significantly higher than that of any other groups（ P〈0. 05）. Significant positive correlation between TBil and serum and urine Cys C levels which were tested on the first day of hospitalization was found（ P〈0. 05）. The level of urine Cys C in moderate group and level of serum and urine Cys C in severe group showed a decrease with time（ P〈0. 05）. Conclusions Renal injury may be found in the neonates with moderate and severe unconjugated hyperbilirubinemia, and the renal function might recover after treatments. Serum and urine Cys C might be useful markers for predicting early kidney injury in neonates.

关 键 词：高胆红素血症 新生儿 肾功能试验 胱抑素C 

分 类 号：R722.1[医药卫生—儿科]