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目的探讨血清胱抑素C(CysC)和尿微量白蛋白(UMA)的联合检测在新生儿窒息早期肾脏损害的诊断意义。方法选择2010年6月至2011年12月本科收治的窒息足月新生儿40例,轻度窒息和重度窒息组按入院先后顺序各纳入20例,同期选择本院分娩的健康足月儿20例为对照组。三组新生儿均于生后24h内抽取静脉血2～3ml,用日本日立公司生产的全自动生化检测仪测定肾功能,乳胶增强散射免疫比浊法测血清CysC,日龄2天内采尿2ml,用免疫比浊法测定UMA。结果窒息组血清CysC和UMA均高于对照组,重度窒息组高于轻度窒息组,差异有统计学意义。重度窒息组、轻度窒息组、对照组分别为CysC(mg/L):(1.80±0.34)、(1.45±0.30)、(1.19±0.27),UMA(mg/L):(21.4±7.1)、(13.5±5.2)、(9.0±3.5),P<0.05。单项检测CysC异常率为60%,UMA异常率为62.5%,而联合检测异常率为90%。结论血清CysC和UMA水平可作为窒息新生儿肾功能损害早期诊断指标,两项联合检测异常率高于单项检测率。
Objective To investigate the diagnostic value of combined detection of serum cystatin C (CysC) and urinary microalbumin (UMA) in the early stage of neonatal asphyxia. Methods From June 2010 to December 2011, 40 full-term neonates with asphyxia admitted to our hospital were enrolled. Twenty patients with mild asphyxia and severe asphyxia were enrolled in order of admission, 20 healthy full-term children delivered in our hospital during the same period, For the control group. The three groups of neonates were drawn 2 ~ 3ml of venous blood within 24 hours after birth. The renal function was measured by automatic biochemical analyzer manufactured by Japan Hitachi. The serum CysC was measured by latex enhanced nephelometry. , UMA was determined by immunoturbidimetry. Results Serum CysC and UMA in asphyxia group were higher than those in control group, and severe asphyxia group was higher than mild asphyxia group, the difference was statistically significant. (1.80 ± 0.34), (1.45 ± 0.30), (1.19 ± 0.27), UMA (mg / L) :( 21.4 ± 7.1) in severe asphyxia group, mild asphyxia group and control group, , (13.5 ± 5.2), (9.0 ± 3.5), P <0.05. The single detection of abnormal CysC rate was 60%, UMA abnormal rate was 62.5%, and the joint detection of abnormal rate was 90%. Conclusions Serum levels of CysC and UMA can be used as an early diagnostic indicator of neonatal renal dysfunction in asphyxia, and the rates of abnormalities in the two combined tests are higher than those of single tests.