血清胱抑素C水平对新生儿窒息肾功能损伤的评价作用

Effect of the serum level of cystatin C on the evaluation of renal function injury after neonatal asphyxia

目的 通过检测窒息新生儿血清胱抑素C（CysC）、血尿素氮（BUN）、血清肌酐（SCr）及计算内生肌酐清除率（Ccr）,探讨血清CysC水平对评估窒息新生儿肾功能损伤的价值.方法 收集86例窒息新生儿（轻度窒息组46例,重度窒息组40例）及30例无窒息新生儿（对照组）的临床资料,于出生后24～72 h抽取股静脉血2ml测定血清CysC、BUN、SCr水平,通过计算Ccr来反映肾小球滤过率（GFR）.结果 轻度窒息组血清CysC、BUN、SCr水平分别为（1.97±0.33）mg/L、（4.97±2.15）mmol/L、（90.41±24.32）μmol/L,重度窒息组分别为（2.65±0.41）mg/L、（10.88±3.31）mmoI/L、（125.82±45.44）μmol/L,对照组分别为（1.24±0.35）mg/L、（4.25±2.04）mmol/L、（58.41±19.22）μmol/L,三组各项指标比较差异均有统计学意义（P值均＜0.01）,轻度窒息组与重度窒息组血清CysC、SCr水平均高于对照组;轻度窒息组CysC反映肾功能损伤的敏感性优于BUN、SCr;窒息新生儿CysC水平与GFR呈负相关（P＜0.01）.结论 血清CysC可作为窒息新生儿肾功能损伤的指标,且敏感性优于BUN、SCr,CysC水平越高,窒息引起的肾损害程度可能越严重.

Objective To explore the diagnostic effect of serum level of cystatin C （CysC） on the renal function after neonatal asphyxia by detection of serum level of CysC, blood urea nitrogen （BUN） and serum creatinine （SCr） and calculation of glomerular filtration rate （GFR） in neonatal asphyxia. Methods The clinical data of 86 neonates with asphyxia （46 cases in mild asphyxia group,40 cases in severe asphyxia group） and 30 neonates without asphyxia （control group） were collected and the serum level of CysC, BUN and SCr were detected at 24 h to 72 h after birth. Results Serum levels of CysC, BUN and SCr were （1.97 ±0.33） mg/L, （4.97 ±2.15） mmol/L, （90.41 ±24.32） μmol/L in mild asphyxia group, （2.65 ±0.41） mg/L, （10.88 ± 3.31） mmol/L, （125.82 ± 45.44） μ mol/L in severe asphyxia group and （1.24 ± 0.35）mg/L, （4.25 ± 2.04） mmol/L, （58.41 ± 19.22） μmol/L in control group, respectively. The differences were significant among three groups and those values in mild and severe asphyxia groups were higher than those in control group. The sensitivity of CysC level to evaluate renal function in mild asphyxia group was better than BUN and SCr level （P〈 0.05）. In neonata] asphyxia, the serum level of CysC had negative correlation with GFR （P 〈 0.01）. Conclusions Serum level of CysC can be adopted to evaluate the renal function after neonatal asphyxia, which is better than BUN and SCr. With a higer level of CysC, the renal function injury may be worse.