新生儿高胆红素血症血清胱蛋白酶C测定及其临床意义

目的 :观察新生儿高胆红素血症血清胱蛋白酶C(CysC)水平的变化 ,评价其对肾功能影响的临床价值。方法 :应用酶联免疫法对 76例新生儿高胆红素血症 (轻度 2 5例 ,中度 2 4例 ,重度 2 7例 )及对照组 30例新生儿血CysC水平测定。结果 :高胆红素血症组CysC(1.8±s 0 .3)mg·L- 1,对照组CysC(1.5 1± 0 .18)mg·L- 1,P <0 .0 1,且血胆红素含量与血CysC水平呈正相关 (r =0 .5 5 6 7,P <0 .0 1)。中、重度高胆红素血症新生儿的CysC水平明显高于对照组 ,P <0 .0 1。中、重度高胆红素血症新生儿高胆红素消退后复查CysC水平明显下降(P <0 .0 1)。肾功能正常。结论 :新生儿高胆红素血症CysC水平升高 ,随着胆红素消退 ,CysC水平下降。血CysC是肾功能敏感的检测指标。

Clinical significance and detection of serum cystatin C in newborn with hyperbilirubinemia

AIM: To evaluate the clinical value of cystatin C (Cys C) the renal function throught monitoring the level of serum Cys C in newborns with hyperbilirubinemia. METHODS: Serum samples were obtained from 76 newborns with hyperbilirubinemia. According to the serum bilirubine, the patients were divided into mild group (n=24), moderate group (n=25 ) and severe group (n=27). There were 30 newborns as control group. ELISA was used to determine the concentration of Cys C in serum. RESULTS: The Cys C level in the newbrons with hyperbilirrubinemia was much higher than that in control group (P<0.01). The Cys C level was (1.8± s 0.3 ) mg·L -1 in hyperbilirrubinemia group, (1.50±0.18) mg·L -1 in control group . The level of bilirubine correlated positively with the concentration of Cys C (r=0.5567, P<0.01). The Cys C level was (1.61±0.24 ) mg·L -1 in mild group, (1.82±0.28) mg·L -1 in moderate group, and (2.04±0.29 ) mg·L -1 in severe group. There was no significant difference between the mild hyperbiliubinemia and control group in Cys C level . When the eased moderate, severe neonatal hyperbilirubinemia was reexamined, the level of Cys C significantly lowered (P< 0.01). CONCLUSION: Serum Cys C value increases in newborn with hyperbilirubinemia, and Cys C decreases following the bilirubin fadeaway . Serum Cys C is regarded as a sensitive marker for assessment of renal dysfunction.