新生儿缺氧缺血性脑病肾功能测定的临床意义

目的 测定缺氧缺血性脑病（简称HIE）新生儿的肾功能,评价肾功能指标在早期诊断及预测HIE脑损伤中的意义,为早期预测脑损伤提供新的方法.方法 足月HIE新生儿89例,其中轻度41例（A组）,中度32例（B组）,重度16例（C组）,正常新生儿30例为对照（D组）.生后24 h检测血清尿素氮（BUN）、肌酐（Cr）、132微球蛋白（β2-MG）.结果 轻度HIE患儿血清Cr、BUN水平与正常新生儿相比差异无统计学意义（P〉0.05）,中、重度HIE患儿血清Cr、BUN水平较正常新生儿明显升高（P〈0.05）;而HIE各组新生儿血β2-MG水平均较正常新生儿升高,且HIE各组间比较差异有统计学意义（P〈0.01）.结论 窒息可引起新生儿脑及肾功能损害,血β2-MG在HIE合并肾脏功能损害的早期评价及预测HIE脑损伤分度及预后中具有一定的应用价值.

Clinical significance of the detection of renal function of neonates with hypoxic ischemic encephalopathy

Objective To detect the renal function of neonates with hypoxic ischemic encephalopathy(HIE),to evaluate the significance of renal function index in early diagnosis and forecast of cerebral injury of HIE,so as to provide a new method for the forecast of cerebral injury.Methods Among 89 full term infant with HIE,there were 41 cases of mild(group A),32 cases of moderate(group B),16 cases of severe(group C) and 30 cases of normal neonates as control(group D).The serum urea nitrogen(BUN),serum creatinine(Cr) and beta-2-microglobulin(β2-MG) were measured at 24 hours after birth.Results There were no significant differences of the levels of serum Cr and BUN between neonates with mild HIE and normal neonates(P > 0.05).The levels of serum Cr and BUN of neonates with moderate and severe HIE were significantly higher than those in normal neonates(P < 0.05);while the levels of β2-MG in all HIE groups were higher than normal neonates,and there were significant differences among all HIE groups(P < 0.01).Conclusion Asphyxia can cause brain and renal impairment,and the serum β2-MG has certain application value in the early evaluation of HIE combined with renal impairment,the forecast of brain impairment indexing and prognosis.