血肌红蛋白、胱抑素C对窒息新生儿早期肾损害的临床研究

目的探讨足月窒息新生儿出生早期血肌红蛋白（Mb）及胱抑素C（Cys—C）浓度变化及对肾功能的影响。方法选择本院新生儿科出生3h内入院的足月窒息新生儿（60例），分为轻度窒息组和重度窒息组，测定生后3h内Mb和CK水平，同时检测Cys—C、BUN、Scr，与无宫内窘迫、窒息及产伤的正常对照组（40例）进行比较分析。结果窒息新生儿出生早期血Mb与CK均高于正常对照组，重度窒息组高于轻度窒息组（P均〈0．05）；Mb与CK浓度呈正相关（重度窒息组r=0．764，轻度窒息组r=0．658，P均〈0．05）；窒息新生儿出生早期Cys—c与BUN、Scr较正常对照组明显升高，Cys—C与BUN、Scr值呈正相关（r=0．618、0．564，P均〈0．05）；Cys—c异常率高于BUN、Scr（轻度组X^2=6．14，重度组X^2=6．73；P均〈0．05）。结论新生儿窒息后缺氧可发生肌肉损伤及早期肾损害，血Mb和Cys—c可作为新生儿早期肾损害的监测指标。

Clinical studies of early renal impairment in asphyxiated newborn blood myoglobin and cystatin C

Objective To explore the correlation between early concentration of serum cystatin C(Cys-c),myoglobin(Mb)and renal damage in full-term newborn with asphyxia.Methods 60 full-term neonates admitted within 3 hours were selected as study group treated in the Department of Neonatology in our hospital,of which were divided into mild asphyxia group and severe asphyxia group.40 full-term normal newborns were selected as control group in the same period without fetal distress,asphyxia,produced injuries.The blood samples were collected within 3 hours after birth,and the levels of Cys-c,Mb,CK,BUN and Scr were detected respectively in the two groups.Results The MB and Cys-cin the study group was significantly higher than the control group(P < 0.05),and the concentrations of each indicators were increased with the aggravation of asphyxia severity.The concentration of Mb was positively correlated with that of CK(severe asphyxia group r = 0.764,mild asphyxia group r = 0.658,P < 0.05).The Cys-c,BUN and Scr in the study group was significantly higher than the control group(P < 0.05),the concentrations of each indicators were increased with the aggravation of asphyxia severity.The concentration of Cys-c was positively correlated with that of BUN,Scr(r = 0.618、0.564,P<0.05).The abnormal rate of Cys-c in the asphyxia group was significantly higher than that of BUN and Scr(mild asphyxia group χ2=6.14,severe asphyxia group χ2=6.73;P<0.05).Conclusion Neonatal asphyxia,hypoxia can occur in muscle injury and early renal damage,serum MB and cystatin C is a early sensitive marker for determining renal damage in the asphyxia neonatorum.