尿白细胞介素18和血清高迁移率族蛋白1对新生儿窒息后急性肾损伤的诊断价值

摘要：目的 探讨尿白细胞介素（IL）-18和血清高迁移率族蛋白1（HMGB1）对新生儿窒息后急性肾损伤的诊断价值。方法 选取本院儿科2015年6月—2017年12月诊治的128例窒息新生儿（轻度窒息组80例，重度窒息组48例）作为研究组，根据出生后1周内是否发生急性肾损伤（AKI）情况分为急性肾损伤组（AKI组，56例）和非急性肾损伤组（非AKI组，72例）；选取本院产科同期出生的64例健康新生儿作为对照组。检测出生后24 h内尿IL-18、血清HMGB1、肌酐（Scr）和尿素氮（BUN）水平；应用受试者工作特征曲线（ROC）评价尿IL-18和血清HMGB1对新生儿窒息后AKI的诊断价值。结果 轻度窒息组和重度窒息组尿IL-18、血清HMGB1、Scr和BUN的水平高于对照组（P＜0.05）；轻度窒息组尿 IL-18、血清 HMGB1、Scr 和 BUN 的水平低于重度窒息组（P＜0.05）。AKI 组尿 IL-18、血清HMGB1、Scr和BUN的水平高于非AKI组（P＜0.05）；尿IL-18和血清HMGB1与Scr和BUN呈正相关（P＜0.05）。ROC曲线分析结果显示，尿IL-18和血清HMGB1对新生儿窒息后AKI的诊断价值优于血清Scr和BUN。结论 尿IL-18和血清HMGB1可作为早期诊断新生儿窒息后AKI的标志物。

The diagnostic value of urinary interleukin-18 and serum high mobility groupprotein-1 in acute renal injury after neonatal asphyxia

Abstract: Objective To investigate the diagnostic value of urinary interleukin-18 (IL-18) and serum high mobilitygroup protein-1 (HMGB1) in acute renal injury after neonatal asphyxia. Methods A total of 128 asphyxiated newborns (80cases in mild asphyxia group and 48 cases in severe asphyxia group) hospitalized in our hospital from June 2015 toDecember 2017 were selected as the study group. According to the occurrence of acute kidney injury (AKI) within one weekafter birth, they were divided into acute kidney injury group (AKI group, 56 cases) and non-acute kidney injury group (nonAKI group, 72 cases). At the same time，64 healthy newborns were selected as control group. The levels of urinary IL-18,serum HMGB1, creatinine (Scr) and urea nitrogen (BUN) were measured within 24 hours after birth. The diagnostic value ofurinary IL-18 and HMGB1 for AKI after neonatal asphyxia were evaluated by using receiver operating curve (ROC).Results The levels of urinary IL-18, serum HMGB1, Scr and BUN were significantly higher in mild asphyxia group andsevere asphyxia group than those in control group (P＜0.05). The levels of urinary IL-18, serum HMGB1, Scr and BUN weresignificantly lower in mild asphyxia group than those in severe asphyxia group (P＜0.05). The levels of urinary IL-18, serumHMGB1, Scr and BUN were significantly higher in AKI group than those in non-AKI group (P＜0.05). The urinary IL-18 andserum HMGB1 were positively correlated with Scr and BUN (P＜0.05). The ROC curve analysis showed that the diagnosticvalue of urinary IL-18 and serum HMGB1 were superior to serum Scr and BUN for AKI after neonatal asphyxia. ConclusionUrinary IL-18 and serum HMGB1 can be used as a marker for the early diagnosis of AKI after neonatal asphyxia.