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目的通过检测窒息新生儿尿微量蛋白和血BUN、Cr的变化探讨尿微量蛋白在窒息新生儿肾脏损害早期诊断的意义。方法窒息组新生儿30例(轻度窒息组15例,重度窒息组15例),对照组为15例健康新生儿,于生后48h内留取新鲜尿液检测尿微量蛋白:尿α1微球蛋白(α1-MG)、β2微球蛋白(β2-MG)、N-乙酰-β-D-氨基葡萄糖苷酸酶(NAG)、转铁蛋白(TRF)、免疫球蛋白(IgG);采静脉血检测血BUN、Cr。结果轻度窒息组与对照组比较:尿α1-MG(8.92±1.25)mg/L、β2-MG(3.06±1.62)mg/L、NAG(14.76±4.69)mg/L水平升高(P(0.01);尿TRF(2.65±1.94)mg/L、IgG(7.39±1.88)mg/L、血BUN(5.23±2.04)mg/L、Cr(64.22±25.11)mg/L水平差异无统计学意义(P(0.05)。重度窒息组与对照组比较:尿α1-MG(12.55±2.44)mg/L、β2-MG(9.35±2.86)mg/L、NAG(29.64±7.43)mg/L、TRF(9.27±2.11)mg/L、IgG(11.97±3.57)mg/L、血BUN(14.36±3.11)mg/L、Cr(120.78±42.19)mg/L水平均显著升高(P(0.01)。重度窒息组与轻度窒息组比较:尿α1-MG、β2-MG、NAG水平差异均无统计学意义(P(0.05),尿TRF、IgG和血BUN、Cr水平显著升高(P(0.01)。单项指标阳性率:尿α1-MG80.0%、β2-MG71.1%、NAG64.4%、TRF37.8%、IgG40.0%,均明显高于血BUN、Cr24.4%,差异有统计学意义(P(0.01)。结论窒息新生儿尿微量蛋白水平有明显变化,其检测阳性率明显高于血BUN、Cr,可以作为新生儿窒息肾脏损害早期的判断指标。
Objective To investigate the significance of urinary microalbuminuria in the early diagnosis of renal damage in neonatal asphyxia by detecting the changes of urinary microalbuminuria and blood BUN, Cr in newborns with asphyxia. Methods Thirty newborns in asphyxia group (15 in mild asphyxia group and 15 in severe asphyxia group) were enrolled in this study. Fifteen healthy newborn infants in control group were enrolled in this study. Fresh urine was collected within 48 hours after birth. Urinary microalbuminuria (Α1-MG), β2 microglobulin (β2-MG), N-acetyl-β-D-glucosaminidase (NAG), transferrin (TRF) and immunoglobulin (IgG) Blood test blood BUN, Cr. Results The levels of urinary α1-MG (8.92 ± 1.25) mg / L, β2-MG (3.06 ± 1.62) mg / L and NAG (14.76 ± 4.69) mg / L were significantly higher in the mild asphyxia group than those in the control group 0.01). There were no significant differences in urinary TRF (2.65 ± 1.94) mg / L, IgG (7.39 ± 1.88) mg / L, blood BUN (5.23 ± 2.04) mg / L and Cr (64.22 ± 25.11) mg / L (P 0.05) .Serum α1-MG (12.55 ± 2.44) mg / L, β2-MG (9.35 ± 2.86) mg / L and NAG (29.64 ± 7.43) mg / L were significantly higher in severe asphyxia group than those in control group (9.27 ± 2.11) mg / L, IgG (11.97 ± 3.57) mg / L, blood BUN (14.36 ± 3.11) mg / L and Cr (120.78 ± 42.19) mg / L respectively. There was no significant difference in urinary α1-MG, β2-MG and NAG levels between severe asphyxia group and mild asphyxia group (P (0.05), urinary TRF, IgG and blood BUN and Cr levels were significantly increased ). The positive rates of single indexes were: urine α1-MG80.0%, β2-MG71.1%, NAG64.4%, TRF37.8% and IgG40.0%, which were significantly higher than that of blood BUN and Cr24.4% (P0.01) .Conclusion The levels of urinary microalbumin in neonates with asphyxia have obviously changed.The detection positive rate of urinary microalbumin in neonates with asphyxia is obviously higher than that of blood BUN and Cr, which can be used as the early judgment indicators of neonatal asphyxia.