妊娠期糖尿病母亲新生儿肾功能变化

Changes in renal function in neonates mother of gestational diabetes

目的探究肾功能常规指标动态监测对评估妊娠期糖尿病母亲新生儿肾功能变化的临床意义。方法择取广东省佛山市南海经济开发区人民医院官窑分院2014年8月～2015年1月收治的妊娠期糖尿病母亲所生新生儿30例为实验组，依据妊娠期糖尿病母亲血糖控制情况将其划分为A组15例（血糖控制理想）及B组15例（血糖控制不理想），另择取同期出生的非妊娠期糖尿病母亲所生新生儿30例为对照组，观察各组血清胱抑素C（Cys—C）、β2微球蛋白（β2-MG）、血尿素氮（SUN）、血清肌酐（Scr）及尿N-乙酰-β—D氨基葡萄糖苷酶（NAG）、全血糖化血红蛋白（HbA1c）、尿微量白蛋白（UMB）检测结果。结果A、B组新生儿Cys—C值分别为（1．42±0．21）mg／L和（1．73±0．21）mg，L，β2-MG值分别为（3．16±0．76）mg／L和（3．73±1．26）mg／L，Scr值分别为（70．14±9．71）μmol/L和（76．21±9．23）±mol／L，均明显高于对照组【（0．93±0．16）、（2．38±0．95）m±L、（61．34±5．73）μmol]，差异均有统计学意义（P〈0．05），而BUN值分别为（2．47±0．40）mmol／L和（1．41±0．42）mmol／L，显著低于对照组[（3．22±0．87）mmol]，差异均有统计学意义（P〈0．05）；而A、B组NAG值则分别为（16．72±6．23）U／L和（55．43±20．74）U／L，UMB值则分别为（19．13±7．34）me,／L和（75．23±23．57）mg／L，HbA1c值分别为（5．56±1．53）％和（12．43±4．03）％，水平均明显高于对照组[（10．83±4．45）U／L、（14．24±5．73）mg／L、（4．83±1．63）％】，差异均有统计学意义（P〈0．05）。结论Cys—C、β2-MG、NAG、UMB及HbA1c等肾功能常规指标动态监测对评估妊娠期糖尿病母亲新生儿肾功能变化具有十分重要的临床意义，能及时发现及预防远期肾功能损害，指导临床治疗，临床上应引起足够重视。

Objective To explore the dynamic detection of renal conventional indicators for assessing changes in renal function in neonates mothers with gestational diabetes clinical significance. Methods 30 newborns born by mothers with gestational diabetes admitted from August 2014 to January 2015 in Guanyao Branch of People＇s Hospital in Nanhai Economy Development District were chosen as the experimental group, and they were divided into group A （ideal glycemic control） and group B （blood glucose control not ideal） according to the blood glucose control of mothers with gestational diabetes, 15 cases in each group. Additionally another 30 cases of neonates born by mothers with gestational diabetes were chosen as the control group, with test results being observed in terms of serum cystatin C （Cys-C）, β2-microglobulin （β2-MG）, blood urea nitrogen （BUN）, serum creatinine （Scr） and urinary N-acetyl -β-D-glucosaminidase （NAG）, whole blood hemoglobin （HbA1c）, microalbuminuria （UMB）. Results In group A and group B, Cys-C levels of newborn were （1.42±0.21） mg/L and （1.73±0.21） mg/L respectively, levels of J32-MG were （3.16±0.76） mg/L and （3.73±1.26） mg/L respectively, levels of Scr were （70.14±9.71） μmol/L and （76.21±9.23）μmol/L respectively. Levels of Cys-C, β2-MG and Scr in group A and group B were apparently higher than those of the control group [（0.93±0.16）, （2.38±0.95）mg/L,（61.34±5.73） μmol/L], the differences were statistical significance （P 〈 0.05）. In group A and group B, levels of BUN were （2.47±0.40） mmol/L and（1.41 ±0.42） mmol/L respectively; levels of BUN were apparently lower than that of the control group [（3.22±0.87） retool/L], the differences were statistical significance （P 〈 0.05）. In group A and group B, levels of NAG were （16.72±6.23） U/L and （55.43±20.74） U/L respectively, levels of UMB were （19.13±7.34） mg/L and （75.23±23.57） mg/L respectively and levels of HbAlo were （5.56±1.53）% and （12.43± 4.03）% respectively; levels of NAG, UMB and HbA1c were apparently higher than those of the control group [（10.83± 4.45） U/L, （14.24±5.73） mg/L, （4.83±1.63）%], the differences were statistical significance （P 〈 0.05）. Conclusion Motion detection of conventional indicators of renal function, such as Cys-C, β2-MG, NAG, UMB and HbA1c are very important clinical assessment of gestational diabetic mothers neonatal renal function, timely detection and prevention of long-term renal function damage to guide clinical treatment, attention should be paid in clinical practice.