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目的探讨重度高未结合胆红素血症新生儿血、尿胱抑素C(Cys C)水平变化及换血疗法对其的影响。方法选择2013年6月至2014年6月本院新生儿科收治的重度高未结合胆红素血症足月儿为观察组,根据治疗方法分为换血组和非换血组。选取同期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,对照组于生后10天内检测上述指标,并对各组进行组间及组内比较。结果共纳入换血组27例,非换血组22例,对照组20例。换血组和非换血组入院第1天血、尿Cys C水平均高于对照组(P<0.05),3组尿素氮及肌酐水平比较差异无统计学意义(P>0.05)。换血组和非换血组血、尿Cys C水平均随时间变化均呈下降趋势,不同时间点比较差异有统计学意义(P<0.05);两组间各时间点血Cys C水平差异均无统计学意义(P>0.05);换血组第4、7天尿Cys C水平低于非换血组,差异有统计学意义(P<0.05)。结论高未结合胆红素血症新生儿可合并肾功能损伤,换血对改善肾小管功能有一定积极意义。
Objective To investigate the changes of serum and urinary cystatin C (Cys C) levels in neonates with severe hyperbilirubinemia and the effect of transfusing therapy on them. Methods From June 2013 to June 2014, the full-term infants with severe hyperbilirubinemia who were admitted to the neonatal department of our hospital were selected as the observation group. According to the treatment methods, they were divided into transfusion group and non-transfusion group. Select the same period of our hospital obstetric childbirth healthy full-term children as the control group. The observation group on the 1st, 4th and 7th day of admission, blood and urine Cys C levels in the control group within 10 days after birth, the above indicators were measured, and the groups were compared between groups and groups. Results A total of 27 cases were included in the transfusion group, 22 cases in the non-transfusion group and 20 cases in the control group. Blood transfusions and non-transfusions were higher on the first day of hospital admission than those in the control group (P <0.05). There was no significant difference in urea nitrogen and creatinine between the three groups (P> 0.05). The levels of blood and urine Cys C in blood transfusion group and non-transfusion group all showed a decreasing trend with time, with significant difference at different time points (P <0.05). There was no statistical difference in Cys C level between two groups (P> 0.05). Urinary Cys C levels were lower on the 4th and 7th day in the transfusion group than in the non-transfusion group (P <0.05). Conclusion Newborns with high un-conjugated bilirubin may have renal dysfunction, and transfusing blood has some positive effects on improving renal tubular function.