血清胱抑素C对新生儿窒息后肾损伤早期诊断的临床意义

目的 研究血清胱抑素C(Cys-C)对新生儿窒息后肾损伤早期诊断的临床意义。方法 窒息患儿按出生后1 min的Apgar评分分为轻度窒息组(192例),重度窒息组(34例),同期选择39例无窒息健康新生儿为对照组。对入住的新生儿抽取静脉血,检测血清Cys-C的水平,结合其血清尿素氮(BUN)及肌酐(Cr)的水平,用Kruskal-Wallis H检验进行组间比较,并做Apgar评分与Cys-C、Cr、BUN及一些临床常用指标的Logistic回归分析。结果 1)Cys-C在重度窒息组,轻度窒息组,对照组的值分别为(2.54±0.48)、(2.16±0.45)、(1.53±0.27)mg/L;Cr在重度窒息组,轻度窒息组,对照组的值分别为(102.32±32.64)、(89.35±26.24)、(69.03±22.00)μmol/L;BUN的值分别为(9.26±4.29)、(8.31±4.50)、(5.31±3.01)μmol/L。且Kruskal-Wallis H检验结果显示Cys-C、Cr、BUN值组间两两比较差异有统计学意义(P<0.01);2)Logistic回归分析显示相比于其他检验值,Cys-C的OR值最小。 结论 Apgar评分越低,血清Cys-C、Cr、BUN值越高;在新生儿窒息后早期得到的各项检验值中,Apgar评分与Cys-C值的相关性最强。

Clinical significance of serum cystatin C for early diagnosis of renal injury induced by asphyxia in neonates

Objective To study the clinical significance of serum cystatin C(Cys-C) for early diagnosis of renal injury induced by asphyxia in neonates. Methods Neonates with asphyxia were divided into mildly asphyxiated group(192 cases)and seriously asphyxiated group(34 cases) by Apgar scores of 1 minute after birth,meanwhile 39 cases of no asphyxia of newborn as control group.The peripheral vein blood samples of neonates were collected,and serum Cys-C was detected.It was compared with serum creatinine( Cr) and urea ( BUN) with Kruskal-Wallis H Test.The related factors of Apgar score such as Cys-C,Cr,BUN and so on were analyzed by Logistic regression analysis. Results 1)The level of Cys-C was (2.54±0.48)mg/L,(2.16±0.45)mg/L,and (1.53±0.27)mg/L in seriously asphyxiated group,mildly asphyxiated group and control group,respectively.The level of Cr was (102.32±32.64)μmol/L,(89.35±26.24)μmol /L and (69.03±22.00)μmol /L respectively.The levels of BUN was (9.26±4.29)μmol/L,(8.31±4.50)μmol /L and (5.31±3.01)μmol/L,respectively.Kruskal-Wallis H tests indicated that there were significant differences between seriously asphyxiated group,mildly asphyxiated group and control group(P<0.01).2)Logistic analysis indicated that the level of serum Cys-C had the least OR value. Conclusions The less Apgar score is,the higher levels of serum Cys-C,Cr and BUN are.There is a best relationship between the Apgar score and the level of serum Cys-C in early examination of asphyxiated neonates.