血清胱抑素C水平在新生儿窒息后肾损伤中的诊断价值

Diagnostic Value of Serum Cystatin C in Kidney Injury Induced by Neonatal Asphyxia

目的探讨血清胱抑素C（Cys—C）水平在新生儿窒息后肾损伤中的诊断价值。方法窒息新生儿60例按出生时Apgar评分分为轻度窒息组（37例）、重度窒息组（23例）；同期选择15例健康足月新生儿作为健康对照组。窒息组新生儿在入院后第1天，健康对照组新生儿在出生1-3d抽取外周静脉血3mL，用免疫比浊法检测各组血清Cys—C水平，并与其血清尿素氮（BUN）、肌酐（Cr）水平比较。采用SPSS12．0软件进行统计学t检验和x^2检验。结果1．在轻度窒息组和重度窒息组中，血清Cys—C水平分别为（1．17±0．18）mg／L和（1．51±0．21）mg／L，血清BUN水平分别为（5．17±2．25）mmol／L和（6．89±2，21）mmol／L，血清Cr的水平分别为（52．59±15．80）μmol／L和（69．19±18．30）μmol／L，健康对照组血清Cys—C、BUN和Cr水平分别为（0．91±0．12）mg／L，（4．35±1．20）mmol／L和（46．55±10．63）μmol／L。与健康对照组相比，轻度窒息组和重度窒息组血清BUN、Cr和Cys—C水平明显升高，差异具有显著性意义（Pa〈0．01）；与轻度窒息组相比，重度窒息组血清BUN、Cr和Cys—C水平有显著升高，差异具有显著性意义（Pa〈0．01）。2．轻度窒息组血清Cys—C、BUN和Cr的异常检出率分别为73％、35％和38％；重度窒息组血清Cys—C、BUN和Cr的异常检出率分别为91％、65％和70％。在轻度窒息组和重度窒息组血清Cys—C的异常检出率显著高于血清BUN和Cr的异常检出率，差异具有显著性意义（P〈0．05，0．01）。3．血清Cys—C与BUN和Cr水平之间呈显著正相关关系（r=0．81，0．84P。〈0．01）。结论Cys—C能较早反映肾脏受损时肾小球滤过率的下降。血清Cys—C可作为新生儿窒息后肾损伤的早期诊断指标之一。

Objective To explore the diagnostic value of serum cystatin C （ Cys - C） in kidney injury induced by neonatal asphyxia. Methods The peripheral vein blood 3 mL was drawn out on the asphyxiated newborn infants in the first day and on control group during 3 days, the level of serum Cys -C was detected by immunoturbidimetry in 37 mildly asphyxiated newborns,23 seriously asphyxiated newborns and 15 full term infants, and the level of Cys - C was compared with serum urea （BUN） and creatinlne（Cr）. Results 1. The level of Cys - C were （ 1.17 ± 0. 18 ） mg/L and （ 1.51±0. 21 ） rag/L, the level of BUN were （ 5.17 ± 2.25 ） mmol/L and （6.89 ± 2. 21 ） mmoL/L and the level of Cr were（52.59 ± 15.80） μmol/L and（69.19 ± 18.30） μmol/L in mildly asphyxiated newborns and seriously asphyxiated newborns, respectively. The levels of Cys- C,BUN and Cr were （0.91 ± 0.12 ） rag/L, （4.35 ± 1.20） mmol/L and （46.55 ± 10.63 ） μmol/L,respectively. Compared with control group, there were a significant differences,in the level of BUN,Cr and Cys -C, all of which had increased in the cases of mildly asphyxiated newborns and seriously asphyxiated newborns （P 〈 0. 01 ） ;Compared with the mildly asphyxiated newborns, the levels of BUN, Cr and Cys - C had increased in the seriously asphyxiated newborns, the differences were obvious （ P 〈 0.01 ）. 2. The abnormal detection rate of Cys - C, BUN and Cr were 73 percent and 35 percent and 38 percent, respectively, in mildly asphyxiated newborns ; the abnormal detection rate of Cys -C, BUN and Cr were 91 percent and 65 percent and 70 percent, respectively, in seriously asphyxiated newborns. The abnormal detection rate of Cys- C was higher than that of BUN and Cr, and the differences were significant （P 〈 0.05,0. 01 ）. 3. There were positive correlations （r = 0. 81 ,0. 84 Po 〈 0.01 ） among the levels of serum Cys - C, BUN and Cr. Conclusion Serum Cys - C can be used as a early diadynamic criterion of kidney injury induced by neonatal asphyxia.