尿微量白蛋白/肌酐比值在窒息新生儿早期肾损害的应用

Clinical application of urinary microalbumin /creatinine ratio in the early kidney damage in asphyxiated nenates

目的：探讨尿微量白蛋白/肌酐比值在判断窒息新生儿早期肾损害的临床价值。方法：选择2012年1月～2013年12月在我院NICU住院的窒息足月新生儿60例为研究组，其中轻度窒息30例，重度窒息30例。随机选择同期本院产科出生的无窒息及无产伤的正常足月新生儿30例。分别检测两组患儿尿微量白蛋白/肌酐比值（mAlb/Cr）。结果：重度窒息组尿mAlb/Cr异常率为73.33％（22/30），轻度窒息组尿mAlb/Cr异常率为26.67％（8/30）（P﹤0.05）；重度窒息组尿mAlb/Cr为（3.26±1.16）mg·mmol-1，明显高于轻度窒息组（2.17±1.02）mg ·mmol-1和对照组的（0.98±0.84）mg·mmol-1（P﹤0.05）；轻度窒息组明显高于对照组（P﹤0.05）。结论：尿微量白蛋白/肌酐比值与新生儿窒息程度和肾损害密切相关，是窒息新生儿早期肾损害监测的灵敏、有效的指标。

Objective：To investigate the diagnostic value of urinary microalbumin/creatinine ratio（ mAlb/Cr）in early kidney damage in newborn infant with asphyxy. Methods：Sixty newborn infants with asphyxy in heng Li hospital from Janu-ary 2012 to December 2013 were included in this study. They were divided into mild asphyxy groups（n=30）and severe asphyxy groups（n=30）. Thirty healthy full term newborn infant were used as the controls. Comparison was made between the three groups about the level of the urinary mAlb/Cr. Results：The abnormity rate of urinary mAlb/Cr of severe asphyxy groups[73. 33%（22/30）]were significantly higher than those of mild asphyxy groups[26. 67%（8/30）]（P﹤0. 05）. There was a significant increases of the level of urinary mAlb/Cr in the severe asphyxy groups（3. 26 ± 1. 16）mg· mmol-1 than those of mild asphyxy groups（2. 17 ± 1. 02）mg·mmol-1 and control groups（0. 98 ± 0. 84）mg·mmol-1 （P﹤0. 05）,and still significantly increases in severe asphyxy groups than those of mild asphyxy groups（P﹤0. 05）. Conclusion：The elevations of urinary mAlb/Cr is closely related to neonatal asphyxy degree and renal injury,which is ef-fective indexes to monitor early renal damage.