尿低分子量蛋白联合检测在新生儿羊水粪染肾损害中的预警作用

目的探讨尿低分子量蛋白联合检测在新生儿羊水粪染肾损害中的临床意义。方法采用病例对照研究的方法,选择120例足月新生儿,其中90例羊水粪染新生儿为研究组,按污染程度分为3组,30名正常羊水新生儿为对照组。测定血气分析、血清尿素氮（BUN）、肌酐（Cr）、尿β2-微球蛋白（β2-MG）、尿α1-微球蛋白（α1-MG）及尿微量白蛋白（MALB）水平。结果随着羊水粪染程度加重,BUN、Cr、尿β2-MG、尿α1-MG及尿MALB水平逐渐增高。研究组和对照组中的BUN和Cr水平比较差异均无统计学意义（P〉0.05）。脐带血pH值（血气分析）、尿β2-MG、尿α1-MG及尿MALB在羊水Ⅲ度粪染组中的含量明显高于对照组,差异有统计学意义（P〈0.05）,而在Ⅰ、Ⅱ度粪染组与对照组比较差异无统计学意义（P〉0.05）。结论尿低分子量蛋白联合检测对羊水粪染引起的肾功能损害早期发现及评估其程度有一定的意义。

Clinical significance of using urinary low molecular weight proteins in the detection of neonatal renal damage associated with meconium-stained amniotic fluid

Objective To investigate the clinical significance of using urinary low molecular weight proteins in the detection of neonatal renal damage caused by meconium-stained amniotic fluid. Methods 120 full-term newborn baby were selected for this study. 90 cases were equally divided into three study groups according to the degree of meconium-stained amniotic fluid （MSAF）, and the other 30 cases with normal amniotic fluid were used as control. The levels of blood gases , serum blood urea nitrogen （BUN）, creatinine （Cr）, urinary β2-microglobulin （β2 -MG）, urinary α1-microglobulin （α1-MG） and urinary microalbumin （MALB） were compared. Results With the increase in the severity of meconium-stained amniotic fluid, the levels of BUN, Cr, urinary β2-MG, urinary α1-MG and urinary microalbumin were increased gradually. The levels of serum urea nitrogen and creatinine in the amniotic fluid Ⅰ , Ⅱ and Ⅲ degree of MSAF group compared with the control group had no statistical significance （P〈0.05）. The values of cord blood pH , urinary β2-MG, urinary α1-MG and urinary microalbumin in the amniotic fluid Ⅲ of MSAF group were significantly from the control group （P〈0.05）, but the level of amniotic fluidⅠdegree and Ⅱdegree of MSAF group compared with control group had no statistical difference （P〈0.05）. Conclusion The of urinary low molecular weight proteins may be used for the early detection of renal damage caused by meconium-stained amniotic fluid.