窒息新生儿肾功能损伤指标检查的临床意义

目的 比较研究反映窒息新生儿肾损伤的实验室指标差异的临床意义。方法 测定38例窒息新生儿尿常规、尿β微球蛋白(β—MG)、血尿素氮(BUN)、血肌酐(Cr)、血尿酸(Ua)的变化。结果 窒息组各项检测指标的异常发生率明显高于对照组(P＜0．05)；重度窒息组各项指标的异常发生率高于轻度窒息组(P＜0．05)；同一组内尿β—MG的异常发生率高于血Cr、BUN、Ua的异常发生率(P＜0．05)；重度窒息组尿常规异常发生率明显高于轻度窒息。结论 尿常规检查和尿β—MG检测是判断窒息后新生儿肾损伤的敏感指标。     

尿β2-微球蛋白测定对新生儿窒息后早期肾损害诊断的临床价值

目的探讨窒息新生儿肾损害与尿β2-微球蛋白(β2-MG)变化的关系.方法将窒息新生儿分为轻度窒息和重度窒息两组,每组按有无肾功能损害再分组并设对照组比较,于生后第1d和第7d检测尿β2-MG的水平.结果①无肾功能损害组尿β2-MG水平比对照组稍高(P>0.05);②并肾功能损害组尿β2-M水平比对照组明显增高(P＜0.05);重度窒息组尿β2-MG水平高于轻度窒息组(P＜0.05).结论尿β2-MG水平的测定可作为判断新生儿窒息程度及肾损害的一个重要指标;对早期肾功能损害的诊断有一定临床价值.     

尿中乳酸水平与新生儿窒息后早期肾损伤的关系

目的 探讨尿中乳酸的变化在新生儿窒息后肾损伤中的意义。方法 对38例足月窒息新生儿(轻度窒息13例,重度窒息25例)和15例正常新生儿的尿中乳酸及反映早期肾损伤指标-β2-MG水平进行了检测。结果 与正常组(24.44±15.90)μmol/L、(0.10±0.01)mg/L]相比,轻度窒息组尿中乳酸、N-、β2-MG水平[(30.11±18.58)μmol/L、(2.80±1.95)mg/L]显著升高(P<0.05或0.01);与轻度窒息组和正常对照组,重度窒息组尿中上述指标的水平[(54.75±15.59)μmol/L、(5.05±2.19)mg/L]也显著升高(P<0.01)。在窒息组内,乳酸水平与Apgar评分呈显著负相关关系(r为-0.68,P<0.01),与β2-MG水平之间均呈显著正相关关系(r为0.85,P<0.01)。结论 窒息新生儿尿中乳酸水平有望成为反映新生儿窒息程度和窒息后肾损伤的早期指标。     

尿钠改变与窒息新生儿肾小管损伤的关系

目的 探讨尿钠水平与窒息新生儿肾小管损伤的关系。方法 采用生化法和放射免疫分析法(RIA)分别检测窒息新生儿尿钠(Una)水平和反映肾小管损伤的指标-β2微球蛋白(β2-MG)。结果 重度窒息组(41.20±3.62mmol/L,4.66±1.85mgol/L)与正常组(22.03±2.58mmol/L,0.09±0.01mg/L)、轻度窒息组(29.40±2.60mmol/L,3.67±2.00mgol/L),以及轻度组与正常组相比较,Una和β2-MG水平显著升高(P<0.05或0.01),且Una和β2-MG水平之间呈显著正相关关系(r为0.72,P<0.05)。结论 尿钠水平的测定有望成为判断窒息程度及肾损伤的一个重要指标。     

尿胱蛋白酶抑制剂C对窒息新生儿肾小管损伤的早期诊断价值

目的探讨尿胱蛋白酶抑制剂C(cystatin C,cys C)水平对窒息新生儿肾小管损伤的早期诊断价值.方法按Ap-gar评分标准将入选新生儿3天以内的尿标本分为正常对照、轻度窒息和重度窒息3组.尿cys C和尿视黄醇结合蛋白(RBP)用酶联免疫吸附法测定,Ucr用全自动散射率比浊法测定,尿IgG、Alb、α1-MG用放射免疫法测定.结果(1)轻度窒息组尿IgG和Alb值与对照组相比无统计学差异(P＞0.05),而α1-MG、RBP和cys C非常显著高于对照组(P＜0.01=;重度窒息组,尿IgG、Alb、α1-MG、RBP和cys C较对照组和轻度窒息组均有显著升高(P＜0.01=.(2)轻度窒息组尿α1-MG异常率为54.55%显著高于IgG、Alb异常率(分别为27.27%和31.82%)(P＜0.05=;尿cys C、RBP异常率分别为68.18%和72.73%非常显著高于尿IgG、Alb异常率(P＜0.01=;尿cys C、RBP异常率显著高于尿α1-MG异常率(P＜0.05=.重度窒息组尿,α1-MG、cys C、RBP的异常率分别达90%、100%和100%,显著高于尿IgG、Alb异常率(55%、65%)(P＜0.05=;尿cys C、RBP异常率均显著高于尿α1-MG异常率(P＜0.05=;尿cys C异常率与尿RBP异常率无显著性差异(P＞0.05).(3)尿cys C、RBP与α1-MG间有良好直线相关性(r分别为0.803和0.831,P＜0.001=.结论尿cys C可作为反映窒息新生几肾小管损伤的早期诊断指标,其敏感性优于尿α1-MG,与尿RBP相似.     

窒息新生儿尿β2微球蛋白检测的临床意义

目的 了解β2-MG评价窒息新生儿肾功能损害的意义.方法 将窒息患儿分为轻度和重度窒息两组.每组按有无肾功能损害再分组并设对照组比较,于生后第1、3天和第7天检测尿β2-MG.结果 ①无肾功能损害组尿β2-MG比对照组稍高(p>0.05)。②并肾功能损害组尿β2-MG比对照组明显增高(p<0.05),重度窒息组高于轻度窒息组(p<0.05).结论 尿β2-WG对判断窒息新生儿合并肾功能损害及估计其程度有一定的意义.     

窒息新生儿尿β2微球蛋白检测的临床意义

目的了解β2-MG评价窒息新生儿肾功能损害的意义.方法将窒息患儿分为轻度和重度窒息两组,每组按有无肾功能损害再分组并设对照组比较,于生后第1、3天和第7天检测尿β2-MG.结果①无肾功能损害组尿β2-MG比对照组稍高(p>0.05),②并肾功能损害组尿β2-MG比对照组明显增高(p<0.05),重度窒息组高于轻度窒息组(p<0.05).结论尿β2-MG对判断窒息新生儿合并肾功能损害及估计其程度有一定的意义.     

尿微量蛋白和尿NAG对妊娠期糖尿病患者肾功能评价的临床意义

目的 探讨尿微量蛋白α1-微球蛋白（α1—MG）、β2-微球蛋白（β2-MG）、白蛋白（mAlb）、免疫球蛋白G（IgG）和N-乙酰-β-D-氨基葡萄糖苷酶（NAG）对妊娠期糖尿病（GDM）患者肾脏损害的早期诊断价值。方法 以30例正常妊娠妇女为正常对照组，60例GDM妇女根据血液HbA1c的水平（HbA1c〈6.5％，6．5～8.0％，〉8．0％）分为3组。所有受试者留晨尿10ml离心，收集上清液，检测尿四项微量蛋白和NAG。结果 GDM1组患者，尿α1-MG、β2-MG与对照组的有显著性差异（P〈0．01），其余各项指标无差异（P〉0，05）；GDM2组患者，尿α1-MG、β2-MG、mAlb与正常对照组和GDM1组的有显著性差异（P〈0．01），尿NAG和IsG尿NAG和IgG与上述两组无显著性差异（P〉0．05）；GDM3组患者，尿NAG和α1—MG、β2-MG、mAlb、IgG与正常对照组和GDM1、2组比较均有显著差异（P〈0．01）。结论 尿微量蛋白和NAG可作为妊娠期糖尿病肾脏损害的早期诊断指标。     

新生儿窒息后血清超敏C反应蛋白和心肌酶的检测及分析

目的探讨超敏C反应蛋白（hs—CRP）和心肌酶的检测在新生儿窒息后心肌损伤中的诊断价值。方法将入选新生儿分为二组，对照组31例，窒息组75例（轻度窒息46例，重度窒息29例），分别测定两组新生儿出生后24h内和第8天的血hs—CRP和心肌酶，并比较分析。结果轻度和重度窒息新生儿血清hs—CRP和心肌酶水平显著高于对照组（P〈0．05和（P〈0．01），重度窒息组血hs—CRP和心肌酶水平高于轻度窒息组（P〈0．05），治疗后窒息组hs—CRP和心肌酶水平明显下降，但重度组仍略高于轻度组，差异无显著性（P〉0．05）。结论新生儿窒息缺氧可导致心肌损伤，血清hs—CRP和心肌酶检测可作为判断心肌损伤及严重程度的指标。     

超敏C反应蛋白与尿β2微球蛋白联合检测对诊断早期糖尿病肾病的临床价值

目的探讨尿β2微球蛋白（β2-MG）和血超敏C反应蛋白（HS-CRP）联合检测对糖尿病早期肾损伤的应用价值。方法用全自动生化分析仪测定89例2型糖尿病患者和50例健康人的血超敏C反应蛋白和尿β2微球蛋白含量。结果糖尿病组β2-MG和HS-CRP明显高于健康人组（P〈0．01），且联合检测阳性率达89．9％，明显高于单项检测。结论尿β2-MG与血HS-CRP是糖尿病早期肾损伤的敏感指标，联合检测更为敏感。     

Level of functioning of siblings and parents of probands of varying degrees of retardation

A further analysis of already published data supports the position that retardates of low ability level less frequently have retarded siblings, retarded parents, and parents low in occupational level than do retardates higher in ability level. The analysis supports the position that there are two types of retarded individuals, persons retarded as a result of gene or chromosomal anomalies, brain injury, etc., who more frequently occur in the lower-level retardate group, and persons whose retardation represents polygenic segregation, who more frequently occur in the higher-level group.     

Modes of Inheritance of Errors of Refraction

Eighteen families in which both parents had refractions within the range of +4·0 D to −4·0 D and axial lengths seen in emmetropia (22·3-26·0 mm) showed coefficients of correlation of the order 0·5 indicative of polygenic inheritance. Such coefficients were seen for axial length (0·407) and for the cornea (0·487), but not for the lens (which is known to be yoked to the axial length). No such coefficients were seen in 19 families in which one of the parents had axial length outside the emmetropic range (nine families with long axes and 10 with short axes).

The pattern of polygenic inheritance for emmetropia (completely correlated optical components) and errors of refraction up to 4·0 D (inadequately correlated components: correlation ametropia) follows that seen in stature and other measurable characters. In contrast the high refractive errors with their abnormal axial lengths (component ametropia) are—like the extremes in stature—pathological anomalies with monofactorial inheritance.

     

Aspects of the problem of direct introduction of Standards of International Organizations

Editorial note. This article is published as part of a discussion. Particular issues of the article are disputable. First of all, this concerns the so-called “folder” method of introduction of international standards for medical devices to domestic medical practice (i.e., by direct translation of the standards and their publication as standardizing documents). Nevertheless, at least one of the problems, the problem of coordination between domestic state standards for medical devices and international recommendations of ISO and IEC, is undoubtedly of topical importance. Advancement of new health service legislation which is to be approved by law-makers will definitely introduce corrections into the present situation. The Editorial Board of Meditsinskaya Tekhnika believes this article will lessen these problems and to be welcomed by readers.