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目的探讨血胱蛋白酶抑制剂C(Cystatin C)在窒息新生儿中的变化及意义,评价其在窒息新生儿早期肾功能损伤中的应用。方法按Apgar评分标准将观察对象分为正常对照组、轻度窒息和重度窒息组。入选新生儿生后48h～72h间采集标本测定血:胱蛋白酶抑制剂C、Cr、CCr及BUN,并进行分析观察。结果正常对照组50例,轻度窒息140例,重度窒息60例。(1)窒息新生儿的血胱蛋白酶抑制剂C,BUN及Cr显著高于正常对照组(P<0.01);重度窒息组血胱蛋白酶抑制剂C,BUN及Cr高于轻度窒息(P<0.01)。(2)有少尿症状的窒息新生儿中测定血胱蛋白酶抑制剂C较Scr,BUN灵敏。(3)血胱蛋白酶抑制剂C推算GFR与内生肌酐清除率相关性好。结论血胱蛋白酶抑制剂C可以反应窒息新生儿肾功中的早期损害,其敏感性优于BUN及Cr;并且血胱蛋白酶抑制剂C可较精确计算GFR。
Objective To investigate the changes and significance of Cystatin C in neonatal asphyxia and evaluate its application in the early renal damage of neonatal asphyxia. Methods According to Apgar score, the subjects were divided into normal control group, mild asphyxia group and severe asphyxia group. Blood samples were collected from 48h to 72h after neonatal birth, and the cystatin C, Cr, CCr and BUN were measured and analyzed. Results 50 cases of normal control group, mild asphyxia 140 cases, severe asphyxia 60 cases. (1) Serum cystatin C, BUN and Cr in neonatal asphyxia group were significantly higher than those in normal control group (P <0.01); Serum cystatin C, BUN and Cr in severe asphyxia group were higher than those in mild asphyxia group (P < 0.01). (2) Determination of serum cystatin C in neonates with oliguric symptoms asphyxiated than Scr, BUN sensitive. (3) Serum cystatin C predicts a good correlation between GFR and endogenous creatinine clearance. CONCLUSIONS: Serum cystatin C responds to early damage in asphyxial neonatal kidney function and is more sensitive than BUN and Cr; and serum cystatin C provides a more accurate estimate of GFR.