新生儿高胆红素血症胆红素峰值与β_2-微球蛋白、胱抑素C和尿素氮及血肌酐的相关性分析

Correlation between bilirubin peak and β_2-microglobulin, cystatin C, urea nitrogen and creatinine in neonatal hyperbilirubinemia

目的分析新生儿高胆红素血症胆红素峰值与β_2-微球蛋白、胱抑素C和尿素氮及血肌酐的相关性。方法回顾性分析长江大学附属仙桃市第一人民医院2015年7月—2016年12月收治的高胆红素血症患儿387例,根据新生儿高胆红素血症专家共识中相关标准分为轻中度组236例和重度组151例。检测比较两组患儿胆红素峰值、β_2-微球蛋白、胱抑素C、尿素氮和血肌酐,并对胆红素峰值与相关指标相关性进行分析。结果两组患者血肌酐比较,差异无统计学意义(P>0.05);重度组患儿胆红素峰值、β_2-微球蛋白、胱抑素C、尿素氮高于轻中度组(P<0.05)。经Spearman相关性分析结果显示,胆红素峰值与β_2-微球蛋白、胱抑素C呈正相关(r=0.323、0.298,P<0.05),存在线性关系;胆红素峰值与尿素氮、血肌酐无相关性(r=0.092、0.126,P>0.05),也不存在线性关系。结论新生儿高胆红素血症胆红素峰值与β_2-微球蛋白、胱抑素C具有明显相关性,且其对评估高胆红素血症导致的肾功能损伤具有一定的临床价值。

Objective To investigate the correlation between bilirubin peak and β_2-microglobulin,cystatin C,urea nitrogen and creatinine in neonatal hyperbilirubinemia. Methods A total of 387 neonates with hyperbilirubinemia were selected from January 2015 to November 2016 in Xiantao First People's Hospital Affiliated to Yangtze University,which were divided into mild to moderate group( n = 236) and severe group( n = 151) according to the relevant standards in the expert consensus of neonatal hyperbilirubinemia. The bilirubin peak,β_2-microglobulin,cystatin C,urea nitrogen and creatinine were detected and compared between the two groups,and the correlation between them were analyzed. Results No statistically significant difference of creatinine was found between the two groups( P > 0. 05); the severe group of bilirubin peak,β_2-microglobulin,cystatin C,urea nitrogen were higher than mild to moderate group( P < 0. 05). There were positive correlation and linear relationships between bilirubin peak and the presence of β_2-microglobulin and cystatin C( r = 0. 323,0. 298,P < 0. 05),there was no correlation and linear relationships between bilirubin peak and urea nitrogen,creatinine( r = 0. 092,0. 126,P >0. 05). Conclusion The bilirubin peak of neonatal hyperbilirubinemia is significantly associated with β_2-microglobulin and cystatin C,and β_2-microglobulin and cystatin C which are used to assess the effects of hyperbilirubinemia with renal damage has a certain clinical value.