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。

EVALUATION OF RENAL TUBULAR FUNCTION WITH URINE SERIES ENZYMES IN HYPERBILIRUBINEMIA NEWBORNS

To explore the changes of Urinary series enzymes activities to evaluate renal tubular function in hyperbilirubinemia newborn. Methods Urinary series enzymes(NAG, GAL,GGT, ALP, LDH)were measured in 38 patients and 50 normal subects, Urinary series enzymes in 32 patients with differnt serum levels of bilirubin were measured before and after treatment. Results The activities of NAG, GAL, ALP, LDH were higher in hyperbilirubinemia group than those in the control group. NAG, ALP, LDH were higher in three different bilirubin serum levels groups, the difference was obviously sig- nificant(P<0.01), After treatment, NAG, ALP and LDH in slight and medium hyperbilirubinemia group were decrease, but no chang in severe hyperbilirubinemia group. The serum bilirubine levels were respectively positive related to the activities of NAG, ALP and LDH(P<0.001). Conclusion Urinary series enzyme changes might be involved in the tubular function damage of hyperbilirubinemia newborn. The tubular function damage in slight and medium hyperbilirubinemia group were reverse, and in severe hyperbilirubinemia group were not reverse temporarily.