摘要
目的探讨新生儿高胆红素血症对肾功能损害机制及早期干预治疗的效果。方法观察组为100例高胆红素血症的新生儿，在入院24h内检测血清胆红素、丙二醛（MDA）、血β2-微球蛋白（β-2MG）及尿微量蛋白（B2-MG、α1-MG、ALB）。对照组为50例正常生理性黄疸新生儿。观察组早期给予抗氧化剂（维生素E，还原性谷胱甘肽）及传统干预措施（原发病治疗，蓝光照射，药物疗法），治疗3d及出院前一天（治疗6d）复查以上项目。结果当未结合胆红素在205．0—256．5μmol／L时，尿β2-MG、α1-MG，血MDA较对照组升高（P〈0．05），当未结合胆红素256．6～342．0μmol／L时，不仅尿β2-MG、α1-MG，血MDA升高，而且血β2-MG升高（P〈0．01，P〈0．05），当未结合胆红素〉342．0μmol／L时，血B2-MG、尿ALB明显增高（P〈0．01，P〈0．05）。经早期干预治疗后，血胆红素下降，血β2-MG、尿微量蛋白基本恢复正常，观察组加抗氧化剂后较对照组恢复更快（P〈0．05）。结论高胆红素血症对新生儿肾小球滤过功能及肾小管重吸收功能造成损害；高胆红素对肾脏功能的损害与高未结合胆红素血症诱导的脂质过氧化作用有关，在传统干预治疗基础上加抗氧化剂治疗效果更好。
Objective To investigate the renal function damage in newborns with hyperbilirubinemia and the effects of early treatment. Methods 100 newborns with hyperbilirubinemia were taken as treatment group. Serum bilirubin, malondialdehyde （ MDA ）, β2-MG, and urine-minim protein （ β2-MG, α1-MG, ALB ） were measured within 24 hours after charge in. 50 healthy newborns had been chosen as controls. Anti-oxidate （ vitamin E and Glutathion） as weel as regular method were given to the treatment group. All the above biochemical indexes were tested in the 3td and 6th day. Results When bilirubin level was in 205.0 -256.5 μmol/L, β2-MG,α1-MG in urine and MDA in blood were higher in treatment group than in control group （ P 〈 0.05 ） ; when unconjugated bilirnbin （ UCB ） was in in 256.6 -342.0 p, mol/L , β2-MG was also raised（P 〈0.01 ,P 〈0.05） ; and when UCB greater than in 342.0 μmol/L , serum β2-MG and urine ALB raised significantly （ P 〈 0.01, P 〈 0.05 ）. After early treatment, bil- irubin decreaed, and,β2-MG, urine-minim protein declined to normal level, with a faster recovery in treatment group than control group （ P 〈 0.05 ）. Conclusions Hyperbilirubinemia may damage the glomerular filtration and renal tubule＇s re-absorption function in neonatals. Lipid peroxidation activated by UCB in Hyperbilirubinemia may cause thease damages. Antioxidant combined with regular treatment could lead better results.
出处
《中国综合临床》
2010年第3期251-253,共3页
Clinical Medicine of China
基金
山东省临沂市科研课题（090103047）
