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目的探讨新生儿高胆红素血症与肾损伤的相关性。方法选择2014年10月至2015年12月我科住院的足月新生儿,根据黄疸干预标准,分为轻度组(胆红素峰值未达光疗标准)、中度组(胆红素峰值达光疗标准,但未达换血标准)和重度组(胆红素峰值达换血标准)。入选患儿黄疸高峰时均检测血胆红素、β_2微球蛋白、胱抑素C、尿素氮和肌酐,应用单因素方差分析、线性回归分析和偏相关分析探讨其相关性。结果共纳入足月新生儿90例,其中轻度组23例,中度组43例,重度组24例。中度组和重度组血β_2微球蛋白高于轻度组,差异有统计学意义(P<0.01),中度组与重度组比较差异无统计学意义(P>0.05);重度组血胱抑素C水平高于轻度组,差异有统计学意义(P<0.05),轻、中度组比较及中、重度组比较差异均无统计学意义(P>0.05)。各组血尿素氮和肌酐比较差异均无统计学意义(P>0.05)。以日龄为控制变量,偏相关分析显示血β_2微球蛋白和胱抑素C与胆红素峰值存在相关性(P<0.05)。回归分析显示血β_2微球蛋白分别与胆红素峰值和日龄呈线性关系(P<0.05);胱抑素C与胆红素峰值呈线性关系(P<0.05),与日龄无显著关系(P>0.05)。结论新生儿高胆红素血症与肾损伤存在相关性,受患儿日龄影响;血β_2微球蛋白和胱抑素C较血尿素氮、肌酐敏感性高,可作为新生儿高胆红素血症相关肾损伤的检测指标。
Objective To investigate the relationship between neonatal hyperbilirubinemia and renal injury. Methods The full-term newborns hospitalized in our department from October 2014 to December 2015 were divided into mild group (bilirubin peak value less than phototherapy standard), moderate group (bilirubin peak value Phototherapy standards, but not up to the exchange standard) and severe group (bilirubin peak exchange standards). Blood bilirubin, β_2 microglobulin, cystatin C, urea nitrogen and creatinine were detected in children with jaundice at the peak. The correlations were analyzed by one-way ANOVA, linear regression analysis and partial correlation analysis. Results A total of 90 full-term newborns were enrolled, of which 23 were mild, 43 were moderate, and 24 were severe. Serum β_2 microglobulin in moderate and severe group was higher than that in mild group (P <0.01), but there was no significant difference between moderate and severe group (P> 0.05) The levels of somatostatin C were higher than those of the mild group (P <0.05). There was no significant difference between the mild and moderate groups and between the moderate and severe groups (P> 0.05). Blood urea nitrogen and creatinine in each group showed no significant difference (P> 0.05). With the age of day as the control variable, partial correlation analysis showed that the blood β_2 microglobulin and cystatin C and bilirubin peak correlation (P <0.05). Regression analysis showed that there was a linear relationship between serum β_2 microglobulin and peak bilirubin and age (P <0.05). Cystatin C showed a linear relationship with peak bilirubin (P <0.05), but had no significant correlation with age (P> 0.05). Conclusion Neonatal hyperbilirubinemia is related to renal injury, which is influenced by the age of children. Blood β_2 microglobulin and cystatin C are more sensitive than blood urea nitrogen and creatinine and can be used as neonatal hyperbilirubinemia Detection of renal damage related to hyperlipidemia.