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目的探讨尿视黄醇结合蛋白(RBP)的变化在新生儿窒息后肾小管损伤中的意义及不同窒息程度新生儿尿RBP值随日龄的动态变化特点。方法对132例足月窒息新生儿(轻度窒息67例,重度窒息65例)和48例足月正常新生儿(对照组)在生后1、3、7、10天用酶联免疫吸附法监测尿RBP。结果①生后d1与对照组相比,窒息组尿RBP值显著升高(P<0.001)。②重复测量资料方差分析显示,不同组别之间存在差异(P<0.01),进一步用SNK检验,得出两两间的差异均有意义(P<0.05)。③不同日龄3组新生儿尿RBP值变化的趋势不同(P<0.01)。④重度窒息组尿RBP7、RBP10值与对照组和轻度窒息组均有差异(P<0.05)。结论①生后7天内新生儿肾小管功能发育不完善。对窒息新生儿应监测肾功能,特别是重度窒息需7-10天以上的肾功能随访。
Objective To investigate the significance of changes of urinary retinol binding protein (RBP) in renal tubular injury after neonatal asphyxia and dynamic changes of RBP in urine of newborns with different degree of asphyxia. Methods 132 cases of full-term asphyxia neonatorum (mild asphyxia 67 cases, severe asphyxia 65 cases) and 48 cases of full-term normal newborns (control group) at 1,3,7,10 days after birth by enzyme-linked immunosorbent assay Urinary RBP was monitored. Results ① Compared with the control group, urinary RBP of asphyxiated group was significantly increased at d1 after birth (P <0.001). (2) The ANOVA analysis showed that there were significant differences among different groups (P <0.01). Further SNK test showed that there was significant difference between the two groups (P <0.05). (3) The changes of RBP in different age groups were different (P <0.01). (4) The RBP7 and RBP10 values in severe asphyxia group were significantly different from those in control group and mild asphyxia group (P <0.05). Conclusion ① Neonatal renal tubular dysfunction developed within 7 days after birth. Neonatal asphyxia should monitor renal function, especially severe asphyxia need more than 7-10 days of renal function follow-up.