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目的探讨尿α1-微球蛋白、尿β2-微球蛋白及尿微量白蛋白联合检测在新生儿窒息肾损伤诊断中的价值。方法选择2014年1月-2016年12月台州市第一人民医院收治的120例新生儿窒息作为观察组,同期正常新生儿120例作为对照组,新生儿窒息根据Apgar评分分为轻度窒息组(Apgar评分0~3分)66例和重度窒息组(Apgar评分4~7分)54例。收集两组新生儿的母亲年龄、胎龄、新生儿性别、新生儿出生体质量、脐血p H值、肌酐、尿素氮、尿α1-微球蛋白、尿β2-微球蛋白及尿微量白蛋白水平等资料。结果观察组年龄、胎龄、新生儿性别、新生儿出生体质量与对照组比较,差异无统计学意义(P>0.05)。观察组脐血p H值低于对照组(P<0.05),观察组肌酐和尿素氮和对照组比较,差异无统计学意义(P>0.05)。观察组尿α1-微球蛋白、尿β2-微球蛋白及尿微量白蛋白均高于对照组(P<0.05)。重度窒息组脐血p H值低于对照组和轻度窒息组(P<0.05),轻度窒息组和对照组脐血p H值比较,差异无统计学意义(P>0.05),对照组、轻度窒息组和重度窒息组肌酐和尿素氮比较,差异无统计学意义(P>0.05)。重度窒息组尿α1-微球蛋白、尿β2-微球蛋白及尿微量白蛋白高于对照组和轻度窒息组(P<0.05),轻度窒息组和对照组尿α1-微球蛋白、尿β2-微球蛋白及尿微量白蛋白比较,比较差异无统计学意义(P>0.05)。结论尿α1-微球蛋白、尿β2-微球蛋白及尿微量白蛋白联合检测可及早发现新生儿窒息肾损伤,并有利于评估其严重程度。
Objective To investigate the diagnostic value of urinary α1-microglobulin, urinary β2-microglobulin and urinary microalbuminuria in the diagnosis of neonatal asphyxia and renal damage. Methods 120 cases of neonatal asphyxia admitted from the First People’s Hospital of Taizhou from January 2014 to December 2016 were selected as the observation group and 120 cases of the normal newborns were used as the control group. Neonatal asphyxia was divided into mild asphyxia group (Apgar score 0 to 3) 66 cases and severe asphyxia group (Apgar score 4 to 7 points) in 54 cases. The mothers’ age, gestational age, neonatal sex, birth weight, neonatal p H value, creatinine, urea nitrogen, urine α1 -microglobulin, urine β2-microglobulin and urine microalbuminuria Protein level and other information. Results There were no significant differences in the age, gestational age, sex of the newborn and birth weight of the newborns in the observation group compared with the control group (P> 0.05). The p value of umbilical cord blood in the observation group was lower than that in the control group (P <0.05). There was no significant difference in creatinine and urea nitrogen between the observation group and the control group (P> 0.05). Urinary α1-microglobulin, urinary β2-microglobulin and urine microalbumin in the observation group were higher than those in the control group (P <0.05). The p value of umbilical cord blood in severe asphyxia group was lower than that in control group and mild asphyxia group (P <0.05), and there was no significant difference in p H between umbilical cord blood in mild asphyxia group and control group (P> 0.05) , Mild asphyxia group and severe asphyxia group creatinine and urea nitrogen, the difference was not statistically significant (P> 0.05). Urine α1-microglobulin, urinary β2-microglobulin and urinary microalbumin in severe asphyxia group were higher than those in control group and mild asphyxia group (P <0.05), urinary α1-microglobulin in urine of mild asphyxia group and control group, Urinary β2-microglobulin and urinary microalbumin, the difference was not statistically significant (P> 0.05). Conclusions Urine α1 -microglobulin, urinary β2-microglobulin and urinary microalbumin combined detection can detect neonatal asphyxia and renal damage early, and help to assess the severity.