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目的探讨血清中性粒细胞明胶酶相关脂质运载蛋白(NGAL)检测在新生儿窒息后急性肾损伤(AKI)早期诊断中的临床价值。方法选择2012年3月至2014年10月出生后因窒息收入本院新生儿科的足月儿为研究对象进行前瞻性研究,根据生后1周内是否发生AKI将患儿分为AKI组和非AKI组。检测患儿生后12 h内血NGAL、尿素氮(BUN)、肌酐(Scr),并进行组间比较。结果共纳入47例新生儿,其中25例并发AKI,发生率53.2%。AKI组和非AKI组患儿性别、胎龄、出生体重、分娩方式、1 min Apgar评分及生后12 h内血BUN、Scr差异均无统计学意义(P>0.05),AKI组5 min、10 min Apgar评分低于非AKI组,差异有统计学意义(P<0.05)。AKI组生后12 h血清NGAL值为(183.8±51.4)ng/ml,非AKI组为(97.6±33.0)ng/ml,两组差异有统计学意义(P<0.05)。结论检测生后12 h内血清NGAL值有助于早期预测新生儿窒息后AKI,为临床早期诊断AKI提供依据。
Objective To investigate the clinical value of serum neutrophil gelatinase-associated lipocalin (NGAL) in the early diagnosis of acute kidney injury (AKI) after neonatal asphyxia. Methods From March 2012 to October 2014, we prospectively studied full-term infants who received neonatal asphyxia in our hospital from March 2012 to October 2014. The children were divided into AKI group and non-AKI group according to whether AKI occurred within 1 week after birth AKI group. Blood NGAL, BUN, Scr were detected within 12 hours after birth and compared among groups. Results A total of 47 newborns were enrolled. Among them, 25 cases were complicated with AKI, the incidence rate was 53.2%. AKI group and non-AKI group had no significant difference in gender, gestational age, birth weight, mode of delivery, Apgar score at 1 min and BUN, Scr within 12 h after birth (P> 0.05) Apgar score at 10 min was lower than that in non-AKI group, the difference was statistically significant (P <0.05). Serum NGAL was (183.8 ± 51.4) ng / ml at 12 h after AKI group and (97.6 ± 33.0) ng / ml at non-AKI group, with significant difference between the two groups (P <0.05). Conclusion Detection of serum NGAL within 12 h after birth can be helpful to predict AKI after neonatal asphyxia in early stage and provide a basis for clinical diagnosis of AKI.