尿大分子碱性磷酸酶在窒息新生儿肾损害早期诊断中的意义  

Significance of urinary high molecular alkaline phosphatase in early diagnosis of renal injury in asphyxiated newborns

作　　者：任青[1] 卢宪梅[1] 邓景惕[2] 胡晓燕[3] 魏伟[1] 

机构地区：[1]山东大学齐鲁医院儿科 [2]加拿大艾伯塔大学 [3]山东大学医学院生物化学教研室

出　　处：《山东大学学报（医学版）》2003年第2期105-108,共4页Journal of Shandong University:Health Sciences

基　　金：山东省卫生厅基金资助项目(1999CAICJB)

摘　　要：目的:研究窒息新生儿肾损害时尿大分子碱性磷酸酶(HMAP)水平的变化及其在肾功能早期损害诊断中的意义。方法:利用抗HMAP的单克隆抗体,用ELISA方法检测69例窒息新生儿(包括轻度窒息39例和重度窒息30例)治疗前后及36例正常新生儿(对照组)尿HMAP的水平,并测定两组尿β2-微球蛋白(β2-MG)和血清尿素氮(BUN)、肌酐(Cr)的水平。结果:窒息组治疗前尿HMAP、β2-MG水平高于治疗后(t=17.01和9.56,P<0.001)和对照组(t=13.38和9.45,P<0.001),且重度窒息组高于轻度窒息组(t=2.48和2.14,P<0.05);窒息组尿HMAP、β2-MG的异常发生率(86.96%和69.57%)高于血清BUN、Cr的异常发生率(24.64%和46.38%)(χ2=7.61,P<0.01),尿HMAP的异常发生率高于β2-MG的异常发生率(χ2=6.13,P<0.05)。尿HMAP与β2-MG呈直线正相关(r=0.648,P<0.001)。结论:窒息新生儿普遍存在肾功能损害,尿HMAP能比β2-MG更灵敏地反映窒息后肾损害的程度,可作为监测窒息新生儿肾损害的早期诊断指标。Objective:To investigate the level changes of urinary high molecular alkaline phos-phatase (HMAP)in asphyxiated newborns with renal injury and offer an early and sensitive diagnostic method for renal dysfunction.Meth ods:Asphyxiated newborns were devided into two groups:mild as-phyxia group(39cases)and serious asphyxia group(30cases).By using monoclonal antibody,ELISA method was adapted to detect the level changes of urinary HMAP before and after treatment in asphyx-ia group(69cases)and the levels of urinary HMAP in normal control group(36cases).The levels of urinaryβ 2 -MG and serum BUN and Cr in two groups were also detected.Results:The levels of uri-nary HMAP andβ 2 -MG in asphyxia group were higher than those in control group(t=13.38and9.45,P<0.001)and decreased significantly after treatment (t=17.01and9.56,P<0.001).The levels of urinary HMAP andβ 2 -MG in serious asphyxia group were higher than those in the mild group (t=2.48and2.14,P<0.05).The mean and standard deviation of urinary HMAP in normal control group were15.53U/L and9.45U/L,and34.43U/L was re garded as the upper limit.The abnormality rates of uri-nary HAMP andβ2-MG in asphyxia group(86.96%and69.57%)were higher than those of serum BUN and Cr (24.64%and46.38%)(χ 2 =7.61,P<0.01).The abnormality rate of urinary HAMP was high-er than that of urinaryβ 2 -MG(χ 2 =6.13,P<0.05).Urinary HMAP was positively correlated withβ 2 -MG(r=0.648,P<0.001).Conclu sion:Renal injury is common in asphyxia newborns.Urinary HAMP is a more sensitive diagnostic parameter than urinaryβ 2 -MG,and may be used for early detection of renal injury in asphyxiated newborns.

关 键 词：婴儿 新生 碱性磷酸酶类 同工酶 抗体 单克隆 肾功能损害 

分 类 号：R722.12[医药卫生—儿科] R446.122[医药卫生—临床医学]