新生儿高胆红素血症355例肾功能分析

Renal function in 355 cases with neonatal hyperbilirubinemia

目的探讨新生儿高胆红素血症（简称高胆）与肾功能的关系和临床意义。方法对355例高胆和39例正常新生儿进行血尿素氮（BUN）、血肌酐（Scr）测定。高胆患儿按血清总胆红素（TBIL）水平分为轻、中、重度3组比较。结果轻度高胆组血清BUN和Scr均高于正常新生儿组和中度高胆组；肾功能损伤发生率，轻度高胆组、中度组和重度组分别为21．4％、6．1％和8．0％，轻度组肾功能损伤发生率高于中度组和重度组，差异均有统计学意义；血TBIL与Scr呈直线正相关（r=0．123），差异有统计学意义，与BUN无相关性。结论轻度高胆就可造成肾功能损伤，日龄越小越易发生肾损伤，血清BUN、Scr作为高胆新生儿。肾功能的诊断指标仍有一定的价值，尤其是在基层医院。

Objective To examine the relation between neonatal hyperbilirubinemia and renal function. Methods Concentrations of blood urea nitrogen （BUN） and serum creatinine （Scr） in 355 neonates with hyperbilirubinemia and 39 healthy neonates （ control group） were determined. Neonates with the hyperbilirubinemia were divided into three groups： the low-grade, the moderate-grade, and the severe-grade, by serum total bilirubin （TBIL）. P.esults BUN and Ser levels in the serum of the low-grade group were higher than those of the control group and the moderate-grade group. The proportion of renal function damage of the low-grade group （21.4 % ） was higher than that of the moderate-grade group （ 6.1% ） and the severe-grade group （ 8.0 % ）. Concentrations of TBIL and the Set were positively related （ r = 0. 123）, which was statistically significant. However, no correlation was observed between TBIL and BUN. Conclusion Low- grade hyperbilirubinemia can cause renal function damage. BUN and the Scr have some value in the diagnosis of renal function among the neonates with hyperbilirubinemia, especially in primary hospitals.