血β2微球蛋白及胱抑素 C对新生儿窒息后早期肾损伤的诊断价值

The Diagnostic Value of Blood β2 - microglobulin and Cystatin - C in Early Kidney Impairment after Neonatal Asphyxia

目的：分析新生儿血β2微球蛋白（β2- microglobin，β2- MG）及胱抑素 C（cystatin C，Cys - C）浓度对新生儿窒息引起的早期肾损伤的临床诊断价值。方法测定150例窒息新生儿（重度窒息组36例、轻度窒息组114例）和150例无窒息新生儿（对照组）生后2小时内血中β2- MG、CysC、BUN、Cr 的含量，比较各组间及组内不同胎龄段患儿4项指标含量。结果各组内不同胎龄段新生儿血β2 MG、CysC、BUN、Cr 含量差异不明显；窒息组血β2- MG、CysC 含量明显高于对照组（ P 〈0.01），重度窒息组明显高于轻度窒息组（ P 〈0.01），轻度窒息组明显高于对照组（P 〈0.05）；三组之间血 BUN、Cr 对比差异无统计学意义。窒息患儿血β2- MG 及 CysC 含量呈正相关（r ＝0.347，P 〈0.01）；在分析不同指标对于重度窒息提示意义的受试者工作特性曲线（ROC）中，血β2- MG 及 CysC 含量的曲线下面积（AUC）均大于血 BUN、Cr（分别为0.786、0.695、0.568、0.555）。结论与血 BUN、Cr 相比，血β2- MG 及 CysC 可更灵敏地预测不同胎龄新生儿窒息后早期肾损伤，为及时进行临床决策和判断预后提供依据。

Objective To analyze the clinical diagnostic value of β2 - microglobulin（β2 - MG）and Cystatin -C（CysC）in early Kidney impairment after neonatal asphyxia. Methods 36 newborns with severe asphyxia and 114 mild asphyxia were chosen as the observation group,and 150 newborns without neonatal asphyxia were chosen as the control group. The levels of serum β2 - MG,Cys - C,BUN and Cr were detected within 2 hours after birth. The four indicators were compared between groups and within groups. Results There were no significant differences in serum levels of β2 - MG,Cys - C,BUN and Cr in newborns of different gestational age. Serum levels of β2 - MG and Cys -C were significantly higher in neonatal asphyxia group than those in control group（P 〈 0. 01）. Serum levels of β2 -MG and Cys - C were significantly higher in severe asphyxia group than those in mild asphyxia group（P 〈 0. 01）. Ser-um levels of β2 - MG and Cys - C were significantly higher in mild asphyxia group than those in control group（P 〈0. 05）. There were no significant differences in BUN and Cr among three groups. Serum levels of β2 - MG and Cys -C in neonatal asphyxia group were positively correlated（r = 0. 321,P 〈 0. 01）. AUC of serum β2 - MG（0. 786）and Cys - C（0. 695）were both larger than those of BUN（0. 568）and Cr（0. 555）in ROC curves analyzing implications of different indicators for severe asphyxia. Conclusion Serum β2 - MG and Cys - C are better marKers than serum BUN and Cr to detect early Kidney damage after neonatal asphyxia,and provide basis for clinical decision - maKing as well as predicting the prognosis.