尿系列酶测定对高胆红素血症新生儿肾小管功能的评价

目的 探讨尿系列酶的改变作为评价高胆红素血症(高胆)新生儿肾小管功能的指标。方法 检测38例高胆新生儿尿系列酶(NAG、GAL、GGT、ALP、LDH)活性与50例正常对照;其中32例不同程度高胆患儿进行治疗前后尿系列酶对照分析。结果 高胆新生儿尿酶NAG、GAL、ALP、LDH活性与对照组比较明显增高,出现显著性差异(P<0.01);三组不同程度高胆新生儿NAG、ALP、LDH活性比较均出现统计学差异(P<0.01),治疗后轻、中度黄疸ANG、ALP、LDH活性与治疗前比较明显减低,出现显著性差异(P均<0.05),重度黄疸NAC、ALP、LDH与治疗前比较无明显差异,P>0.05;血清总胆红素水平与NAG、ALP、LDH呈正相关关系。结论 尿系列酶改变可以反映高胆新生儿时肾小管功能不同程度的受损;轻、中度高胆新生儿肾小管功能受损是可逆的,重度肾损害恢复慢。     

尿系列酶测定对高胆红素血症新生儿肾小管功能的评价

目的探讨尿系列酶的改变作为评价高胆红素血症(高胆)新生儿肾小管功能的指标.方法检测38例高胆新生儿尿系列酶(NAG、GAL、GGT、ALP、LDH)活性与50例正常对照;其中32例不同程度高胆患儿进行治疗前后尿系列酶对照分析.结果高胆新生儿尿酶NAG、GAL、ALP、LDH活性与对照组比较明显增高,出现显著性差异(P＜0.01);三组不同程度高胆新生儿NAG、ALP、LDH活性比较均出现统计学差异(P＜0.01),治疗后轻、中度黄疸ANG、ALP、LDH活性与治疗前比较明显减低,出现显著性差异(P均＜0.05),重度黄疸NAG、ALP、LDH与治疗前比较无明显差异,P＞0.05;血清总胆红素水平与NAG、ALP、LDH呈正相关关系.结论尿系列酶改变可以反映高胆新生儿时肾小管功能不同程度的受损;轻、中度高胆新生儿肾小管功能受损是可逆的,重度肾损害恢复慢.     

新生儿高胆红素血症尿微量蛋白的测定

高胆红素血症是新生儿常见疾病,其对中枢神经系统的损害已被广泛认识和重视,但对肾功能的影响国内外报道较少。为了探讨新生儿高胆红素血症对肾功能的影响,我们对35例高胆红素血症的足月新生儿进行了尿4种微量蛋白的测定,现报道如下。     

足月新生儿高间接胆红素血症与中枢损害关系的探讨

新生儿高间接胆红素血症可引起胆红素脑病,脑干诱发电位已被国内外许多学者作为各种中枢神经损伤检测的一种手段。本文通过观察足月新生儿胆红素浓度、胆红素／白蛋白（B／A）比值与脑干听觉诱发电位（ABR）异常及神经症状的关系,探讨高间接胆红素血症引起脑损害的高危因素及防治措施。     

不同胎龄高胆红素血症新生儿血清胱抑素C及β_2-微球蛋白水平变化的意义

目的观察不同胎龄高胆红素血症新生儿血清胱抑素C(Cys C)及β2-微球蛋白(β2-MG)水平变化,探讨高胆红素血症对不同胎龄新生儿肾功能的影响。方法应用酶联免疫吸附法对98例不同胎龄高胆红素血症新生儿(足月儿45例,早产儿53例)及对照组(足月儿及早产儿各20例)新生儿的血清β2-MG、Cys C水平进行测定,采用SPSS13.0软件进行统计学处理。结果轻度高胆红素血症组足月儿血清β2-MG、Cys C与对照组比较差异无统计学意义(Pa>0.05),但明显低于重度高胆红素血症组足月儿(Pa<0.01);轻度高胆红素血症组早产儿血清β2-MG和Cys C明显高于重度高胆红素血症组早产儿及对照组早产儿(Pa<0.01);重度高胆红素血症组新生儿血β2-MG和Cys C水平明显高于对照组(Pa<0.01)。血清β2-MG和Cys C水平与血胆红素水平呈正相关、与胎龄呈负相关(r=0.563 8,-0.724 6,Pa<0.01;r=0.581 7,-0.831 8,Pa<0.01)。重度高胆红素血症组新生儿胆红素消退期β2-MG、Cys C水平较黄疸高峰期明显下降(Pa<0.01)。结论高胆红素血症特别是重度高胆...     

新生儿高胆红素血症与肺炎的关系

新生儿高股红素血症与肺炎的关系临床上少见报道，本文分析56例新生儿总胆红素＞300Iμmol／L者其与肺炎的关系：临床资料1．一般情况：男38、女18、男女比为2．1：1，足月儿39、早产儿17，孕龄最小为33周，体重最低为Z000克。围产期情况：剖腹产8例，胎膜早破10例，最长1例早破膜20天，羊水已发臭。脐绕须5例，l例脐扭转10圈。入院日龄：＜7天与＞7天入院各为49与7例，入院最早为生后3O分钟，最晚1例为ZI天。治疗结果：治愈53例，好转2例，自动出院1例。2．肺部检查：肺部有中小湿呷音老5例，呼吸音降低2例，支气管肺泡呼吸音（简称双相…     

新生儿高胆红素血症与多脏器损害的关系探讨

传统医学认为新生儿高胆红素血症(高胆)除高浓度外,一般不会引起人体损害,但近几年有人发现高胆时新生儿的脏器损害是客观存在的,并可能造成永久性损害,主张积极治疗。本文对此问题进行探讨并报告如下。1对象与方法1·1对象根据新生儿高胆诊断标准,以我院2003~2005年因高胆收治住院患儿82例为对象,出生体重≥2 500 g;男40例,女42例;日龄2~7 d,平均5 d;原发疾病母乳性黄疸40例,头颅血肿8例,胎粪排出延迟5例,纳差5例,不明原因24例。排除早产、窒息、溶血、感染等因素。1·2方法全部病例做脑干听觉诱发电位(BAEP)、肾功能(BUN、Cr)、心肌酶…     

新生儿高胆红素血症与脏器损害

新生儿高胆红素血症的主要危险因素包括母乳喂养、ABO或Rh血型不合性溶血病、早产、感染、头颅血肿、窒息、红细胞葡萄糖石．磷酸脱氢酶缺陷病、尿苷二磷酸葡萄糖醛酸基转移酶1A1基因变异。     

新生儿高胆红素血症及胆红素脑病闪光视觉诱发电位的变化

目的 观察新生儿高胆红素血症及胆红素脑病闪光视觉发电位的改变。方法 应用日本产ＮＥＵＲＯＰＡＣＫ－Ｖ型发电位仪对３０例高胆红素血症新生儿、９例胆红素脑病新生儿及２０例正常新生儿进行闪光视觉诱发电位（Ｆ－ＶＥＰ）检测。结果 高胆红素组与对照组比较,两组间Ｆ－ＶＥＰ变化无显著性差异;胆红素脑病组较 Ｖ波潜伏期显著延长及Ⅲ－Ⅴ波间期显著延长。结论Ｆ－ＶＥＰ可较灵敏地反映胆红素脑病中枢神经功能状态的变化,     

Effect of hypercapnic acidosis on renal function in the newborn rabbit

Anaesthetized mechanically ventilated newborn rabbits were exposed to different degrees of hypercapnia. One hour of normocapnia was used as a control period. Renal function studies demonstrated an increase in renal vascular resistance with a concomitant decrease in effective renal plasma flow in all hypercapnic animals, combined with a less pronounced decrease in glomerular filtration rate. Filtration fraction rose significantly. A decrease in systemic blood pressure was only observed when the PaCO2 exceeded 100 mm Hg combined with an arterial pH below or equal to 7.10. We conclude that normoxemic hypercapnia in the newborn rabbit leads to an increase in renal vascular resistance and suggest that the renal vasoconstriction predominates at the level of the efferent arteriole.     

Effects of asphyxia on renal function in the newborn piglet

This investigation was undertaken to determine the nature of acute alterations in renal function following the production of hypoxemia, hypercarbia, and acidosis in newborn piglets 6-96 hr of age. After completion of the surgical procedure piglets were allowed to recover from the effects of anesthesia. When respiratory dead space was increased arterial oxygen tension decreased whereas arterial carbon dioxide tension and hydrogen ion concentration increased. There was little change in glomerular filtration rate. Total renal blood flow decreased and renal vascular resistance increased significantly (504 +/- 78 mm Hg/liter/mm/m2 to 1422 +/- 504). There was no change in distribution of intrarenal blood flow. Sodium excretion and urinary flow rate demonstrated significant parallel increases following the increase in dead space. Plasma renin concentration increased from 67 to 110 ng/ml.     

The effects of losartan on renal function in the newborn rabbit

The low GFR of newborns is maintained by various factors including the renin-angiotensin system. We previously established the importance of angiotensin II in the newborn kidney, using the angiotensin-converting enzyme inhibitor perindoprilat. The present study was designed to complement these observations by evaluating the role of angiotensin-type 1 (AT(1)) receptors, using losartan, a specific AT(1)-receptor blocker. Increasing doses of losartan were infused into anesthetized, ventilated, newborn rabbits. Renal function and hemodynamic variables were assessed using inulin and para-aminohippuric acid clearances as markers of GFR and renal plasma flow, respectively. Losartan 0.1 mg/kg slightly decreased mean blood pressure (-11%) and increased diuresis (+22%). These changes can be explained by inhibition of the AT(1)-mediated vasoconstrictive and antidiuretic effects of angiotensin, and activation of vasodilating and diuretic AT(2) receptors widely expressed in the neonatal period. GFR and renal blood flow were not modified. Losartan 0.3 mg/kg decreased mean blood pressure significantly (-15%), probably by inhibiting systemic AT(1) receptors. GFR significantly decreased (-25%), whereas renal blood flow remained stable. The decrease in filtration fraction (-21%) indicates predominant efferent vasodilation. At 3 mg/kg, the systemic hypotensive effect of losartan was marked (mean blood pressure, -28%), with decreased GFR and renal blood flow (-57% and -51%, respectively), a stable filtration fraction, and an increase in renal vascular resistance by 124%. The renal response to this dose can be considered as reflex vasoconstriction of afferent and efferent arterioles, rather than specific receptor antagonism. We conclude that under physiologic conditions, the renin-angiotensin is critically involved in the maintenance of GFR in the immature kidney.     

The effects of dimethyl sulfoxide on renal function of the newborn rabbit

The purpose of this study was to establish the effects of intravenous dimethyl sulfoxide (DMSO), a solvent used in a wide variety of products (medicines), on kidney function in the newborn rabbit. Three groups of anesthetized, ventilated, normoxemic 4- to 8-day-old New Zealand White rabbits received a 90-min intravenous infusion of DMSO at a dose of 1.11 (group 1), 16.5 (group 2) or 111 microgram/ kg/h (group 3). The only change observed in the animals of group 1 was a significant increase in filtration fraction (FF; p < 0. 001), whereas no change at all was observed in the renal functional parameters of the animals of group 2. The highest dose of DMSO (group 3), however, caused a very significant (p < 0.001) decrease in renal blood flow (RBF) and a rise in renal vascular resistance (RVR), FF and urine volume (UV). Glomerular filtration rate (GFR) and systemic parameters such as pH, mean arterial blood pressure and heart rate did not change. The rise in GFR, RVR, UV (group 3 vs. 2) and FF (groups 3 vs. 2 and 2 vs. 1) was dose-dependent. No significant dose-dependent decrease in RBF was found. To the best of our knowledge, there are no previous reports on the effect of DMSO on renal function in the solvent doses used in this study. We ascribe the reported effects to the 'immaturity' of the newborn rabbit kidney. Consequently, this agent should be used with great caution in developmental studies.     

The effects of theophylline on renal function in the premature newborn.

The effects of aminophylline on renal function in 10 premature infants with idiopathic apnea are evaluated. The percent increases in creatinine clearance (128 +/- 339%, mean +/- SD) and sodium clearance (196 +/- 304%, mean +/- SD) are variable while the percent increase in fractional sodium excretion (69 +/- 109%, mean +/- SD) is significant. This effect is postulated to be at the proximal tubule and may be modified by the effects of postnatal age and infusion of albumin. Gestational age, birth weight, heart disease, water and sodium intake and ventilatory support did not appear to influence the results. Hyponatremia is a potential consequence of theophylline therapy for apnea.     

Effect of caffeine on thyroid and pituitary function in newborn rats

The possibility that caffeine, a central nervous system stimulant used in neonatal apnea, may produce acute or chronic changes in growth hormone (GH), thyroxine (T4) and thyrotropin (TSH) was studied in the newborn rat. Five-day-old rats were separated into three groups: control (0) group receiving saline, Group I (low dose caffeine) receiving 5 mg/kg and Group II (high dose caffeine) receiving 50 mg/kg. Acute effects were studied at 2, 4, and 24 h after injection. Chronic effects were studied 24 h after the last of 10 daily injections. GH, T4, and TSH were measured by radioimmunoassay and caffeine by high pressure liquid chromatograph. GH was increased at all times and all doses after a single injection of caffeine. After chronic therapy, the increase in GH was small, suggesting depletion of pituitary reserve. A high dose of caffeine had a biphasic effect on T4 with an increase at 4 h and a decrease at 24 h. Thyrotropin-releasing hormone (TRH)-induced TSH release at 24 h was not influenced by caffeine administration. Chronic caffeine therapy stimulated both T4 and TSH; however, TRH-stimulated TSH release was decreased, suggesting that chronic therapy may blunt pituitary TSH response.