血清胱抑素C对新生儿窒息后肾损伤的诊断价值探讨

目的：探讨血清胱抑素C（Cystatin C,Cys C）水平在新生儿窒息后肾损伤中的诊断价值。方法：选取窒息新生儿120例,其中轻度窒息组74例、重度窒息组46例,同时选取30例健康足月新生儿作为健康对照组;窒息组新生儿在入院后第1 d、健康对照组新生儿在生后1-3 d各抽取外周静脉血3 ml,用乳胶颗粒增强比浊法检测各组血清Cys C水平,与其血清尿素氮（BUN）、肌酐（Cr）水平比较,并进行统计学处理。结果：轻度窒息组血清Cys C、BUN和Cr水平有显著升高,差异具有统计学意义（P〈0.01）;轻度窒息组血清Cys C、BUN和Cr的异常检出率分别为73%、35%和38%,重度窒息组血清Cys C、BUN和Cr的异常检出率分别为91%、65%、和70%,在轻度窒息组和重度窒息组血清Cys C的异常检出率显著高于血清BUN和Cr的异常检出率,差异有统计学意义（P〈0.05、P〈0.01）,血清Cys C与BUN和Cr水平之间呈显著正相关关系（r=0.81、r=0.84,P〈0.01）。结论：Cys C能较早反映肾脏受损时,肾小球滤过率的下降;血清Cys C可作为新生儿窒息后肾脏损伤的早期诊断指标之一。

Exploration on Diagnostic Value of Serum Cystatin C in Kidney Injury Induced by Neonatal Asphyxia

Objective：To explore the diagnostic value of serum Cystatin C in Kidney injury induced by neonatal asphyxia.Methods：120 asphyxiated neonates were chosen,among whom 74 were mildly asphyxiated and 46 seriously asphyxiated.In the meantime,30 healthy full term neonates were chosen as a control group,The peripheral vein blood 3 ml was drawn out on the asphyxiated neonates on the first day in hospital and on the control group during 1～3 days after birth.The level of serum Cys C was detected by latex particle enhanced turbidimetry,was compared with serum urea（BUN） and creatinine（Cr） and was processed by statistics.Results：In the mildly asphyxiated neonates,the level of serum BUN、Cr and Cys C increased obviously,and the difference was significant（P〈0.01）.The abnormal detection rate of serum Cys C,BUN and Cr was 73 percent、35 percent and 38 percent respectively,In the seriously asphyxiated neonates,the abnormal detection rate of serum Cys C BUN and Cr was 91 percen、65 percent and 70 percent respectively,In the mildly asphyxiated neonates and the seriously asphyxiated neonates,the abnormal detection rate of serum Cys C was obviously higher than that of serum BUN and Cr.And the difference was significant（P〈0.05、P〈0.01）.There were positive correlations（r=0.81、r=0.84,P〈0.01） among the levels of serum Cys C、BUN and Cr.Conclusion： Cys C can reflect earlier the decline of glomerular filtration rate when kidneg is injured.Serum Cys C can be used as an early diagnostic criterion of kidney injury induced by neonatal asphyxia.