新生儿高胆红素血症中胱抑素C的变化及临床意义

目的 了解胱抑素C(CysC)在新生儿高胆红素血症中的变化.方法 104例高胆红素血症新生儿为高胆组,根据其血总胆红素水平分为轻、中、重3组,各28、58、18例;同时选择40例非高胆红素血症新生儿为非高胆组.测定血尿素氮(BUN)、肌酐(Cr)和CysC,并比较高胆组与非高胆组,以及轻、中、重高胆组新生儿之间的差异;分析各指标与血总胆红素的相关性.结果 高胆组和非高胆组新生儿的BUN、Cr均在正常范围,差异无统计学意义(P ＞ 0.05);高胆组新生儿的CysC高于非高胆组,差异有统计学意义(P ＜ 0.05);轻、中、重度高胆组新生儿的CysC逐渐增高,差异有统计学意义(F ＝ 5.39,P ＜ 0.05).新生儿的血总胆红素水平与CysC水平呈直线正相关(r ＝ 0.3,P ＜ 0.05).结论 高胆红素血症时,新生儿的CysC增高并随着血总胆红素水平升高而加剧,可能成为判断高胆红素血症时早期肾功能损害的敏感生物学指标.

The changes and its clinical significance of serum cystatin C in newborns with hyperbilirubinemia

Objective To explore the changes of serum cystatin C in hyperbilirubinemia newborns.Methods According to total bilirubin levels in serum,104 hyperbilirubinenia newborns were divided into mild,moderate and severe groups,28,58,18 patients for corresponding group.And 40 non-hyperbilirubinemia newborns were selected as control group.The serum levels of urea nitrogen(BUN),creatinine(Cr)and cystatin C(CysC)were measured.The differences between hyperbilirubinemia and non-hyperbilirubinemia,as well as among mild,moderate and severe groups,were compared and the correlations were also analyzed.Results The serum levels of BUN and Cr were within normal range,there was no statistical significance between hyperbilirubinemia and non-hyperbilirubinemia newborns(P > 0.05).However,the level of serum cys C in hyperbilirubinemia newborns was higher than that in non-hyperbilirubinemea newborns(P > 0.05).There were significant differences in the levels of serum CysC among mild,moderate and severe hyperbilirubinemia newborns(F = 5.39,P < 0.05).A positive linear correlation was found between total bilirubin and serum CysC of newborns(r = 0.3,P < 0.05).Conclusions In hyperbilirubinemia newborns,the level of serum CysC increases with the elevated total bilirubin concentration,is more likely to become a sensitive indicator for diagnosis of early renal dysfunction in hyperbilirubinemia.