血、尿β_2-MG及尿NAG测定与新生儿窒息后肾功能评价  

Significance of Determinations of Blood and Urinary β_2-Microglobin and Urinary NAG in Evaluation of Renal Function After Asphyxia in Neonates

作　　者：周传新[1] 

机构地区：[1]中山大学附属第五医院儿科,广东珠海519000

出　　处：《中国当代儿科杂志》2003年第6期512-514,共3页Chinese Journal of Contemporary Pediatrics

摘　　要：目的　新生儿窒息可引起全身多脏器功能损害 ,该文通过观察窒息新生儿血、尿 β2 微球蛋白 (β2 MG)及尿N 乙酰 β D 氨基葡萄糖苷酶 (NAG)含量的变化以评价新生儿窒息后肾功能的改变。 方法　采用放射免疫法和对硝基酚比色法对 2 8例窒息新生儿 (又分为重度窒息组 1 3例和轻度窒息组 1 5例 )和 1 6例正常新生儿血、尿β2 MG及尿NAG同时进行检测。结果　窒息组血、尿 β2 MG及尿NAG值 [(4 .4 6± 1 .4 2 )mg/L ,(2 .6 9± 1 .80 )mg/L ,(1 3.6 8± 2 .0 1 )U/mmol.Cr]明显高于正常组 [(2 .97± 1 .2 4 )mg/L ,(0 .96± 0 .82 )mg/L ,(6 .1 2± 1 .1 6 )U/mmol.Cr](P <0 .0 1 )。重度窒息组血、尿 β2 MG及尿NAG值 [(4 .99± 1 .2 8)mg/L ,(3.86± 1 .1 4 )mg/L ,(1 3.94± 3.82 )U/mmol.Cr]高于轻度窒息组 [(4 .30± 1 .2 1 )mg/L ,(2 .93± 0 .87)mg/L ,(9.6 8± 1 .2 7)U/mmol.Cr](P<0 .0 5 )。窒息新生儿尿 β2 MG较血 β2 MG升高更明显 (P <0 .0 1 )。结论　血、尿 β2 MG及尿NAG测定对早期评价新生儿窒息后肾功能损害 ,尤其是对肾小球或肾小管的损害定位。Objective Neonatal asphyxia may lead to multiple organ lesions. This paper aims at studying the changes of β 2 microglobin (β 2 MG) in blood and urine and N Acetyl β D Glucosaminidase (NAG) in urine so as to evaluate the renal function in neonates after asphyxia. Methods Radioimmunity and colorimetry were used to simultaneously measure β 2 MG levels in blood and urine and urinary NAG level in 28 neonates with neonatal asphyxia and 16 healthy neonates. Results Compared with healthy infants, the levels of β 2 MG in blood and urine and the level of NAG in urine [( 4.46 ± 1.42 ) mg/L vs ( 2.97 ± 1.24 ) mg/L, ( 2.69 ± 1.80 ) mg/L vs ( 0.96 ± 0.82 ) mg/L, ( 13.68 ± 2.01 U/mmol.Cr vs ( 6.12 ± 1.16 ) U/mmol/Cr, respectively] significantly increased in neonates with asphyxia (P< 0.01 ). The levels of β 2 MG in blood and urine and the NAG level in urine [( 4.99 ± 1.28 ) mg/L, ( 3.86 ± 1.14 ) mg/L, ( 13.94 ± 3.82 ) U/mmol.Cr, respectively] were significantly higher in the neonates with severe asphyxia than those in neonates with mild asphyxia [( 4.30 ± 1.21 ) mg/L, ( 2.93 ± 0.87 ) mg/L, ( 9.68 ± 1.27 ) U/mmol/L.Cr, respectively](P< 0.05 ). The levels of β 2 MG in urine increased more obviously than the β 2 MG level in blood in neonates with asphyxia (P< 0.01 ). Conclusions β 2 MG in blood and urine and NAG in urine may be useful indexes for the early evaluation of renal function, especially of the orientation of injury of glomerular or renal tubular and of the severity of renal lesions in neonates following asphyxia.

关 键 词：血 尿Β2-MG 尿NAG 新生儿窒息 肾功能 低氧血症 酸中毒 

分 类 号：R722.12[医药卫生—儿科] R446.1[医药卫生—临床医学]