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目的 探讨尿系列酶的改变作为评价高胆红素血症(高胆)新生儿肾小管功能的指标。方法 检测38例高胆新生儿尿系列酶(NAG、GAL、GGT、ALP、LDH)活性与50例正常对照;其中32例不同程度高胆患儿进行治疗前后尿系列酶对照分析。结果 高胆新生儿尿酶NAG、GAL、ALP、LDH活性与对照组比较明显增高,出现显著性差异(P<0.01);三组不同程度高胆新生儿NAG、ALP、LDH活性比较均出现统计学差异(P<0.01),治疗后轻、中度黄疸ANG、ALP、LDH活性与治疗前比较明显减低,出现显著性差异(P均<0.05),重度黄疸NAC、ALP、LDH与治疗前比较无明显差异,P>0.05;血清总胆红素水平与NAG、ALP、LDH呈正相关关系。结论 尿系列酶改变可以反映高胆新生儿时肾小管功能不同程度的受损;轻、中度高胆新生儿肾小管功能受损是可逆的,重度肾损害恢复慢。
Objective To investigate the changes of urinary enzymes as indicators of renal tubular function in neonates with hyperbilirubinemia (hypercholesterolemia). Methods Urinary enzymes (NAG, GAL, GGT, ALP, LDH) in 38 cases of hyperbilirubinemia were detected with 50 normal controls. 32 cases of hyperbilirubinemia patients with different levels of high urinary tract before and after treatment of urine enzyme control analysis. Results The activities of NAG, GAL, ALP and LDH in urethral hypercholesterolemia were significantly higher than those in control group (P <0.01). The activities of NAG, ALP and LDH in three groups of neonates with hyperbilirubinemia were statistically significant (P <0.01). The activity of ANG, ALP and LDH in mild and moderate jaundice after treatment were significantly lower than those before treatment (P <0.05), and the levels of NAC, ALP and LDH in severe jaundice were significantly lower than those before treatment No significant difference, P> 0.05; serum total bilirubin levels and NAG, ALP, LDH was positively correlated. Conclusions Changes of urinary enzymes may reflect different degrees of renal tubular dysfunction in neonates with hyperbilirubinemia. Renal tubular dysfunction in neonates with mild and moderate hyperbilirubinemia is reversible and the recovery of severe renal damage is slow.