新生儿窒息后不同时期肾功能检测的临床意义

目的分析足月窒息新生儿不同时期的肾功能变化特点，探讨窒息与肾损害关系。方法收集足月窒息新生儿107例，分为轻度窒息组63例、重度窒息组44例，与健康对照组30例，检测窒息后24h、第3天、第7天的血清BUN、Cr、UA、β2-MG水平，比较其在各组间的差异。结果107例窒息新生儿中出现肾损害36例，其中轻度窒息组发生14例、重度窒息组发生22例，窒息后肾损害发生率33．6％。血清BUN、Cr、UA在24h内重度窒息组与轻度窒息组、轻度窒息组与健康对照组比较，差异无统计学意义（P〉0．05）；第3天重度窒息组与轻度窒息组、轻度窒息组与健康对照组比较有统计学意义（P〈0．05）；第7天重度窒息组与轻度窒息组、轻度窒息组与健康对照组比较无统计学意义（P〉0．05）；血清β2-MG在24h、第3天、第7天，重度窒息组与轻度窒息组、轻度窒息组与健康对照组比较，差异有统计学意义（P〈0．05），与24h和第3天相比，窒息各组在第7天均有所下降。结论新生儿窒息后易出现肾损害，与窒息程度正相关。因此血清BUN、Cr、UA、β2-MG检测可以用于窒息后肾损害的诊断和监测，尤其血清β2-MG检测更有价值。

Clinical significance for testing renal function at different periods after asphyxia in newborns

Objective To analyze the characteristic of renal function at different periods after asphyxia in newborns, and investigate the relationship between asphyxia and impairment in kidney. Methods A total of 137 subjects were collected in our hospital, including mild asphyxia group （ n = 63 ）, severe asphyxia group （ n = 44 ） and healthy control group （ n = 30 ）. The differences of BUN ,Cr,UA and β2-Mg in serum in different groups were compared on the 24th hour,the third day and the seventh day after asphyxia. Results 36 cases were found developing renal impairment in 107 asphyxiaed newborns with an incidence of 33.6% ;among them, 14 cases were in the mild asphyxia group and 22 cases were in the severe asphyxia group. There was no statistical significance among these three groups at BUN, Cr and UA within 24 hours （ P 〉 0. 05 ） and on the seventh day. However, compared with the mild asphyxia group and the healthy control group, the severe asphyxia group had the highest BUN, Cr and UA （ P 〈 0.05 ） on the third day. The β2-MG in serum had statistical significance between the severe asphyxia group and the mild asphyxia group on the 24th hour, the third day and the seventh day（ P 〈0. 05 ）. On the seventh day, the β2-MG was lower in 2 asphyxia groups than on the 24th hour and on the third day. Conclusion Impairment of renal function is likely to develop after asphyxia in newborns, which is positively associated with the degree of asphyxia. The BUN, Cr, UA in serum are abnormal in severe asphyxia group on the third ady. The β2 -MG in serum is abnormal in mild asphyxia group and the severe asphyxia group at different periods. On the third day, the β2-MG is obviously different from that on the 24th hour or on the seventh day. It is considered that serum BUN, Cr, UA and β2-MG test can be used in the diagnosis and monitoring of renal damage after asphyxia. The detection of serum β2-MG is especially more valuable.