尿微量蛋白在新生儿窒息肾损害早期诊断中的意义

目的探讨尿微量蛋白测定在新生儿窒息早期肾损害的临床意义。方法63例窒息足月新生儿（窒息组），平均日龄（1±1．8）d，其中轻度窒息36例，重度窒息27例，于出生后第2d及第5d检测尿中尿清蛋白（ALB）、α1微球蛋白（α1—MG）、转铁蛋白（TRF）、β2微球蛋白（β2-MG）的水平及尿常规，同时查血尿素氮（BUN）及肌酐（Cr）。30例正常足月新生儿用作对照组。结果窒息组新生儿出生后第2d的尿ALB、（α1—MG、TRF、β2-MG均显著高于对照组，均P〈0．01，第5d尿ALB、TRF、α1-MG、β2-MG仍显著高于对照组，P〈0．05，0．05，0．01，0．01。重度窒息组生后第2d的尿ALB、α1-MG、TRF、β2-MG均显著高于轻度窒息组，均P〈0．01，第5d的尿ALB、TRF、α1—MG、β2-MG仍显著高于轻度窒息组，P〈0．05，0．05，0．01，0．01。尿ALB、α1—MG、TRF、β2-MG的高低与窒息的程度呈正相关，均P〈0．05。结论联合检测尿ALB、α1-MG、TRF、β2-MG能更敏感地评估新生儿窒息早期。肾损伤的程度及肾脏功能，为临床诊疗提供依据。

Significance of urinary microproteins in early diagnosis of kidney damage in asphyxiated neonates

Objective To investigate the clinical significance of urinary microproteins in the early diagnosis of kidney damage in asphyxiated neonates.Methods Specimens of urine were collected from 63 full-term neonates with asphyxia, aged （1 ±1.8） days, 36 with mild asphyxia and 27 with severe asphyxia, to examine the levels of albumin （ALB）, transferring （TRF）, α 1-microglobulin （α1-MG）, and β2-MG, and routine urianalysis was conducted 2 days and 5 days after birth. Meanwhile blood samples were collected to test the blood urea nitrogen （BLN） and serum creatinine （Cr）. Thirty age-matched healthy normal full-term newborns were used as control group.Results The ALB, α1-MG, TRF, and β2-MG levels 2 days after birth of the asphyxia group were all significantly higher than those of the control group, allP 〈0.01 and the urine ALB, TRF, α1-MG, and β2-MG levels 5 days after birth of the asphyxia group were still significantly higher than those of the control group, P 〈0.05, 0.05, 0.01, 0.01. The ALB, α1-MG, TRF, and β2-MG levels 2 days after birth of the severe asphyxia group were all significantly higher than those of the mild asphyxia group, all P 〈0.01 and the urine ALB, TRF, α1-MG, and β2-MG levels 5 days after birth of the severe asphyxia group were still significantly higher than those of the mild asphyxia group, P 〈0.05, 0.05, 0.01, 0.01. The levels of ALB, α1-MG, TRF, and β2-MG were positively correlated to the severity of asphyxia, all P 〈0.05; Conclusion Combined tests of ALB, α1-MG, TRF, and β2-MG sensitively assess early kidney damage and kidney function in neonates with asphyxia, thus providing a basis for clinical diagnosis and treatment.