尿α_1-微球蛋白在新生儿窒息后肾损伤中的意义

The significance of urine α_1-microglobulin in renal injury when after neonatal asphyxia

目的探讨尿α1-微球蛋白在新生儿窒息后肾功能损伤的意义。方法窒息新生儿58例按出生时Apgar评分分为轻度窒息组32例、重度窒息组26例;同期选择30例健康足月新生儿作为健康对照组。所有患儿在生后3d内采用酶联免疫吸附法(ELISA)检测尿α1-微球蛋白(α1-MG)浓度,并与其血清尿素氮(BUN)、肌酐(Cr)水平进行对比。结果重度窒息组和轻度窒息组的BUN、Cr和尿α1-MG水平高于健康对照组,且重度窒息组BUN、Cr和尿α1-MG水平显著高于轻度窒息组,差异均有统计学意义(P<0.01)。轻度窒息组和重度窒息组尿α1-MG异常检出率均显著高于同组血清BUN和Cr异常检出率,差异均有统计学意义(P<0.05或P<0.01)。结论尿α1-MG是评价新生儿窒息后肾功能损害的敏感指标。

Objective To discuss the clinical significance of α1-microglobnlin in Urine for estimating renal dysfunction induced by neonatal asphyxia. Methods 58 cases of neonatal asphyxia were divided into mild asphyxia group（ 32 cases） , severe asphyxia group（26 cases）according to Apgar score. 30 cases of healthy full-term newborns were choiced as a control group in the same period. The level of α1 -MG in urine detected by immunoturbidimetric assay was compared with serum urea （BUN） and creatinine（Cr） on the third day after birth. Results BUN,Cr and urine α1-MG in severe asphyxia group and the mild asphyxia group were higher than that in healthy control group, as while as the severe asphyxia group of BUN, Cr and urine α1-MG level was significantly higher than the mild asphyxia group, the difference were statistically significant （P 〈 0. 01 ）. Mild asphyxia group and the severe asphyxia group of urine α1 -MG abnormal detection rate were significantly higher than those with abnormal serum BUN and Cr detection rates, the differences were statistically significant（P 〈 0. 05 or P 〈 0. 01 ）. Conclusion Urinary α1 -MG was an sensitive indicator to evaluate renal dysfunction after neonatal asphyxia.