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目的:探讨尿微量蛋白检测在窒息新生儿急性肾脏损伤病情评估中的应用价值。方法:选取窒息新生儿52例为病例组,其中轻度窒息新生儿36例,重度窒息新生儿16例,同时选取同期出生的健康新生儿30例为健康对照组。检测两组新生儿的尿微量α1微球蛋白(α1-M)、尿微量白蛋白(Alb)、尿微量β2微球蛋白(β2-M)、肌酐(Scr)和尿素氮(BUN)水平并进行对比。结果:轻度窒息组和重度窒息组新生儿Scr、BUN升高的比例对比,差异无统计学意义(P>0.05);病例组新生儿出生第3天的尿α1-M为(9.31±2.54)mg/L、尿Alb为(28.71±7.59)mg/L、尿β2-M为(4.02±1.19)mg/L,出生第7天的尿α1-M为(6.36±2.21)mg/L、尿β2-M为(3.02±1.33)mg/L,均显著高于健康对照组(P<0.05);重度窒息组新生儿出生第3天的尿α1-M为(11.67±3.18)mg/L、尿Alb为(38.23±6.94)mg/L、尿β2-M为(5.09±1.27)mg/L,出生第7天的尿α1-M为(8.31±2.31)mg/L、尿β2-M为(3.91±1.80)mg/L,均显著高于轻度窒息组(P<0.05)。结论:窒息新生儿尿微量蛋白的检测有助于早期肾脏损伤的诊断,有利于评估肾脏损伤的严重程度,指导临床的诊治。
Objective: To investigate the value of urinary microalbuminuria in the assessment of acute renal injury in asphyxia neonates. Methods: Fifty-two newborns with asphyxia were selected as the case group, including 36 asymptomatic neonates and 16 asphyxia neonates. Thirty healthy newborn infants born at the same time were selected as healthy control group. Urinary microalbuminuria (α1-M), urinary albumin (Alb), microalbuminuria (β2-M), creatinine (Scr) and blood urea nitrogen (BUN) comparing. Results: There was no significant difference in the proportion of Scr and BUN among newborn infants with mild asphyxia group and severe asphyxia group (P> 0.05). The urinary α1-M of newborns on day 3 was (9.31 ± 2.54) (4.02 ± 1.19) mg / L for urine Alb and (6.36 ± 2.21) mg / L for urine on day 7 of birth, respectively. The urinary Alb was (28.71 ± 7.59) mg / (3.02 ± 1.33) mg / L, urinary β2-M was significantly higher than that of the healthy control group (P <0.05). Urine α1-M of newborns in severe asphyxia group was (11.67 ± 3.18) mg / L Urinary Alb was (38.23 ± 6.94) mg / L and urinary β2-M was (5.09 ± 1.27) mg / L respectively. Urinary α1-M was 8.31 ± 2.31 mg / (3.91 ± 1.80) mg / L, all of which were significantly higher than that of mild asphyxia group (P <0.05). Conclusion: The detection of urinary microalbumin in neonates with asphyxia is helpful for the diagnosis of early renal injury, which is helpful to evaluate the severity of renal injury and guide the clinical diagnosis and treatment.