血清胱抑素C检测对新生儿窒息患儿肾功能评估的临床意义

Clinical value of serum cystatin C in determination of renal function impairment in neonatal asphyxia

目的探讨血清胱抑素C(cystatinC,CysC)水平变化对新生儿窒息患儿肾功能损害评估的意义。方法 2007年5月至2009年12月收治的146例窒息患儿,轻度窒息组70例、重度窒息组76例。于入院24h内采血测定CysC浓度,同时测定血肌酐(SCr)及血尿素氮(BUN)等变化,分析CysC与SCr、BUN等肾功能指标的关系。选择同期无窒息、无肾脏疾病的住院新生儿100例为对照组。结果与对照组相比,重度窒息组血清CysC、SCr及BUN水平显著升高。CysC在轻度窒息组的异常率为17.10%,高于SCr异常率,但差异无统计学意义(P>0.05),显著高于BUN异常率(χ2=6.05,P<0.05);重度窒息组CysC异常率上升至44.7%,显著高于SCr及BUN异常率(χ2=6.52、9.66,P均<0.05)。结论测定血清CysC水平可作为监测窒息新生儿肾功能的指标,其敏感度优于血清SCr及BUN。

Objectives To evaluate the clinical value of serum cystatin C（Cys C） in determination of renal function impairment in neonates with asphyxia.Methods The serum concentration of Cys C,SCr and BUN was measured in 146 neonatal asphyxia（70 mild and 76 severe asphyxia） 24hr-36hr after birth.Control group included 100 neonates without perinatal asphyxia and other factors that can result in renal function impairment.Relationship between the changes of level of serum Cys C and SCr,BUN were analyzed.Results（1） There were no significant differences in concentration of serum Cys C,SCr and BUN between mild neonatal asphyxia and the controls,while the levels of Cys C,SCr and BUN in severe asphyxia newborns were markedly higher than that of the controls.（2） The rate of higher serum Cys C in severe asphyxia newborns was 44.7%,which is higher than that of BUN and SCr（both P〈0.05）.Conclusions Serum Cys C is superior to serum SCr and serum BUN in evaluation of kidney function.