窒息新生儿尿视黄醇结合蛋白、N-乙酰-β-D-氨基葡萄糖苷酶检测的应用

Clinical application of urinary retinal binding protein and N-acetyl-β-D-glucosaminidase in asphyxia new-borns

目的探讨尿视黄醇结合蛋白(RBP)、尿N-乙酰-β-D-氨基葡萄糖苷酶(NAG)在窒息新生儿肾功能损害的应用价值。方法选取轻度窒息足月儿37例,重度窒息足月儿26例,分别检测出生后首次和第24小时尿RBP/Cr、尿NAG/Cr,并同时测血尿素(Urea)和血肌酐(Cr),比较4项检测结果,并分析其统计学差异。结果重复窒息组两次尿RBP/Cr、NAG/Cr均值均高于轻度窒息组,差异有统计学意义(P<0.05)。在轻度窒息组,尿RBP/Cr异常率明显高于另3项指标,差异有统计学意义(P<0.01);尿NAG/Cr异常率比血Urea和血Cr高,差异有统计学意义(P<0.05)。在重度窒息组,尿RBP/Cr异常率也最高,与尿NAG/Cr比较,差异有统计学意义(P<0.05),与血Urea、血Cr比较,差异有统计学意义(P<0.01);尿NAG/Cr异常率高于血Urea,差异有统计学意义(P<0.05),但与血Cr之间的异常率比较,差异无统计学意义(P>0.05)。结论尿RBP/Cr和尿NAG/Cr可作为早期监测窒息新生儿肾功能损害的敏感指标,其中尿RPP/Cr比尿NAG/Cr更敏感。

Objective To study the applicable value of urinary retinal binding protein（RBP） and N-acetyl-β-D-glucosaminidase（NAG） in renal dysfunction of asphyxiated newborns. Methods Thirty- seven term infants with mild asphyxia（mild asphyxia） and 26 term infants with severe asphyxia（severe asphyxia group） were enrolled in the study. Urinary RBP/Cr and urinary NAG/Cr were measured at 0 h, 24 h timepoints after birth, and blood Urea and Cr were measured simultaneously. The results were compared and statistically analyzed. Results The means of RBP/Cr and NAG/Cr in severe as- phyxia group were significantly higher than those in mild asphyxia group; there were significant differ ences（P〈0.05） between the two groups. In mild asphyxia group, the abnormality rate of urinary RBP/Cr was obviously higher than the other three indices（P〈0.01）, and urinary NAG/Cr had signif- icant higher abnormality rate than blood Urea and Cr. In severe asphyxia group, urinary RBP/Cr ab normality rate was the highest among all indices, and higher than that of urinary NAG/Cr（P〈0.05） and blood Urea, Cr（P〈0.01） ; the abnormality rate of urinary NAG/Cr was higher than that of blood Urea（P〈0.05）, but there was no significant difference of abnormality rate between blood Cr and urinary NAG/Cr（P〉0.05）. Conclusion Urinary NAG/Cr and urinary RBP/Cr can be used as the sensi tive indices for the early monitoring of renal dysfunction of asphyxiated newborns; and the former is more sensitive.