尿微量蛋白测定在新生儿窒息中的意义

Meanings of urinary microprotein in neonates with asphyxia

目的 探讨尿微量蛋白测定在新生儿窒息中的意义。方法 运用散射比浊法测定 31例足月窒息和 38例正常新生儿的尿IgG、TRF、Alb、β2 -MG、α1-MG ,把 1minApgar评分 8～ 10分的 38例分为A组 (无宫内缺氧史 ,n =2 0 )和B组 (有宫内缺氧史 ,n =18) ;把 31例窒息儿分为C组 (1minApgar评分 4～ 7分 ,n =14)和D组 (1minApgar评分 0～ 3分 ,n =17) ;E组(5minApgar评分≥ 6分 ,n =19)和F组 (5minApgar评分 <6 ,n =12 )。结果 B组尿 β2 -MG、α1-MG较A组明显升高 (P <0 0 1) ;D组尿IgG、TRF、Alb、β2 -MG、α1-MG均较C组明显升高 (P <0 0 0 5 ) ;F组尿IgG、TRF、Alb、β2 -MG、α1-MG均较E组升高 (P <0 0 1)。结论 宫内缺氧可造成新生儿肾小管功能障碍 ;新生儿窒息后 ,不仅有肾小管功能障碍 ,而且也有肾小球功能障碍 ;窒息越重 ,时间越长 ,肾小球和肾小管的损伤越严重。

Objective To explore the meanings of urinary microprotein in neonates with asphyxia.Methods Urinary immunoglobulin G(IgG),transferring(TRF),albumin(Alb),β 2-microglobulin(β 2-MG),α 1-microglobulin(α 1-MG)were measured by scattering turbidimetry not only in 31 full-term asphyxiated neonates,but also in 38 normal full-term neonates.38 normal full-term neonates(1 minute Apgar score 8～10) were divided into group A(no hypoxia in gestation,n=20)and group B(hypoxia in gestation, n=18),31 asphyxiated neonates were classified group C (1 minute Apgar score 4～7,n=14) group D (1 minute Apgar score 0～3,n=17),group E (5 minute Apgar score≥6,n=19)and group F (5 minute Apgar score<6,n=12).Results In contrast, urinary β 2-MG, α 1-MG of group B were significantly higher than those of group A ( P <0.01).Urinary IgG,TRF,Alb,β 2-MG,α 1-MG of group D were significantly higher than those of group C ( P <0.005).Urinary IgG, TRF, Alb, β 2-MG, α 1-MG of group F were significantly higher than those of group C ( P <0.005 ). Urinary IgG, TRF, Alb, β 2-MG, α 1-MG of group F were significantly higher than those of group E too ( P <0.01).Conclusion Hypoxia in gestation could result in neonatal renal tubular dysfunction.Asphyxiated neonates were accompanied by renal glomerulus dysfunction,as well as renal tubular dysfunction.If asphyxia was severe and long,the damages of renal tubular and glomerulus were heavy.Urinary microglobulin could monitor the varieties of asphyxiated neonatal renal function.