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目的观察不同类型、程度母乳性黄疸患儿血清胱抑素C(Cys C)的变化,评价胆红素对肾功能的影响以及早期干预治疗的价值。方法 2010年8月—2011年8月53例母乳性黄疸患儿为观察组,分为早发型25例,晚发型28例,再根据胆红素水平分为轻、中度两组。选取同期自然分娩、健康无黄疸的足月儿30例为对照组。观察组于入院当日黄疸高峰期、黄疸消退期及对照组取静脉血2～3 ml,检测并比较血清Cys C、总胆红素、肌酐(Cr)及尿素(BUN)水平。结果早发型母乳性黄疸患儿高峰期轻、中度组血清Cys C水平均较对照组升高,差异有统计学意义(P<0.01),中度组在黄疸消退期血清CysC水平仍较对照组高(P<0.05);晚发型母乳性黄疸患儿高峰期中度组血清Cys C水平较对照组明显升高(P<0.01);中度组黄疸高峰期血清Cys C,早发型比晚发型高,差异有统计学意义(P<0.05);治疗前后Cr、BUN水平观察组与对照组均无明显差异(P>0.05)。结论早发、晚发型母乳性黄疸均可引起肾功能的异常,早发型比晚发型影响更明显。
Objective To observe the changes of serum cystatin C (Cys C) in children with different types and degree of breast milk jaundice and evaluate the effect of bilirubin on renal function and the value of early intervention. Methods August 2010-August 2011 53 cases of breast milk jaundice in observation group, divided into early-onset 25 cases, 28 cases of late-onset, then according to bilirubin levels were divided into mild and moderate groups. Select the same period of natural childbirth, healthy jaundice in 30 cases of full-term children as the control group. The observation group was given 2 ~ 3 ml venous blood on the day of jaundice, jaundice extinction and the control group on the day of admission. The levels of serum Cys C, total bilirubin, creatinine (Cr) and urea (BUN) were detected and compared. Results The serum levels of Cys C in patients with early-onset breast-milk jaundice at the peak and the moderate were higher than those in the control group (P <0.01). The serum levels of CysC in patients with moderate-onset jaundice (P <0.05). The level of serum Cys C in patients with late-onset breast milk jaundice at the peak was higher than that in the control group (P <0.01). The serum Cys C, (P <0.05). There was no significant difference between Cr and BUN levels before and after treatment in the observation group and the control group (P> 0.05). Conclusion Early onset and late onset of breast milk jaundice can cause abnormal renal function, early onset of hair than the late-onset more obvious.