母乳性黄疸患儿血清胱蛋白酶抑制剂C的变化及临床意义

Changes and clinical significance of serum Cys-C in the patients with breast milk jaundice

目的通过测定母乳性黄疸患儿血清CysC、β2-MG的含量,探讨母乳性黄疸对肾脏滤过功能的影响。方法CysC采用ELISA法测定,β2-MG采用放射免疫法测定。对40例母乳性黄疸患儿(按血清胆红素水平分为A组:胆红素<12.9mg/dl;B组:胆红素≥12.9mg/dl)和30例正常健康儿(对照组:C组)血清中CysC和β2-MG的含量与血肌酐(血Cr)、血尿素氮(BUN)进行比较。结果A组与C组CysC、β2-MG的含量差异无统计学意义(P>0.05),B组与C组、B组与A组CysC、β2-MG的含量差异均有统计学意义(P<0.001),且随黄疸消褪,血CysC、β2-MG水平明显下降,血CysC与β2-MG水平呈正相关(r=0.582,P<0.05);所有母乳性黄疸患儿血Cr、BUN全部正常,三组相比较无统计学意义。结论母乳性黄疸患儿血清胆红素≥12.9mg/dl时,可导致肾小球滤过功能受损,血CysC与β2-MG水平可早期敏感地反应肾小球滤过功能的变化。

Objective To explore the effect to renal filtration function of breast milk jaundice by mearsurining the serum Cys C,β2 - MG levels in the children with breast milk jaundice. Methods IApplying ELISA and radioimmunity to detect the Cys C, β2 - MG respectively in 40 patients with breast milk jaundice （ group A： bilirubin 〈 12.9mg/dl; Group B： bilirubin ≥ 12.9 mg/dl; and 30 healthy children （ group c） were as control ）, and comparing with serum Cr and BUN. Results IThere was no significant difference of Cys C, β2 - MG levels betwecn Group A and group C. However, there were significant differences of Cys C,β2 -MG levels between Group B and Group C, between Group B and Group A （ P 〈 0. 001 ）, and with the jaundice blood Cys C,β2- MG levels signitleantly decreased. Serum Cys C levels were positively correlated with β2- MG （ r = 0. 582, P 〈 0.05 ）. All of the patients with the breast milk jaundice had normal serum Cr and BUN. Conclusion IIn the patients with breast milk jaundice, when serum bilirubin is over 12.9 mg/dl, it may injury the renal filtration function, and serum Cys C and β2 - MG can serve as two sensitive and early indexes of renal filtration function.