新生儿高胆红素血症尿RBP检测意义的探讨

Study on Clinical Significance of Determination of Urinary Retinal-Binding Protein in Newborns with Hyperbilirubinemia

目的探讨尿视黄醇结合蛋白(RBP)在新生儿高胆红素血症时的浓度变化及其检测在判断新生儿肾脏损伤状况和治疗过程中的临床意义。方法选择患高胆红素血症的住院新生儿(足月顺产)38例,分别于入院时、治疗中期、治疗后期及出院前四个阶段用经皮胆红素测定仪测定胆红素浓度,并同时收集新鲜尿液,采用ELISA方法检测尿RBP浓度,同时与30例正常新生儿的尿RBP浓度比较。结果高胆红素血症组的尿RBP为412.5±165.3μg/L,正常对照组为168.8±109.7μg/L,前者明显高于后者,两组间存在非常显著性差异(P<0.01)。高胆红素组四个阶段的尿RBP(μg/L)和胆红素浓度(μmol/L)分别为:412.5±165.3、318.5±129.8;301.6±115.1、223.6±104.4;229.1±108.9、169.7±87.6;172.7±98.3、113.2±51.5。显示尿RBP浓度随着胆红素浓度的高低而变化,呈现显著的正相关。结论尿RBP检测是一项监测肾功能损害的灵敏指标,对新生儿高胆红素血症时的肾功能损害监测和疗效判断都具有很实用的临床意义。

Objective To study the changes of urinary retinal-binding protein（RBP） concentration in newborns with, hyperbilirubinemia in order to explore its clinical significance in early diagnosis and treatment of renal dysthnction. Method 38 full-term infants of hospitalization suffered from hyperbilirubinemia were selected. Their contents of bilirubin were detected at four stages ： hospitalization, metaphase and telophase of treatment, and before discharge. Meanwhile,the fresh urine was collected. RBP concentation was determined with ELISA method and was compared with that in 30 normal infants. Resultts Urinary RBP level in newborns with hyperbilirubinemia（412.5 ± 165.3μg/L） was significantly higher than that in control group（ 168.8 ± 109.7μg/L, P 〈 0.01 ）. Urinary RBP （μg/L） and bilirubin （μmol/L） concentrations in hyperbilirubinemia group at four stages were 412.5 ± 165.3,318.5 ± 129.8;301.6 ± 115.1,223.6 ± 104.4;219.1 ± 98.9,169.7 ±87.6; 173.7 ± 92.3,113.2 ± 51.5, respectively, which showed that urinary RBP concentration changed with the change of bilinibin concentration. There was a significant positive correlation. Conclusions As a sensitive index of renal dysfunction,urinary RBP has very practical clinical significance in the monitoring of renal lesion and efficacy judgement.