高胆红素血症新生儿血清胱抑素C水平的变化及临床意义

摘要

目的 分析高胆红素血症新生儿血清胱抑素C水平变化的临床意义.方法 选择新生儿科收治的95例足月高胆红素血症新生儿(高胆红素血症组),按照血清胆红素水平分成轻度组、中度组和重度组,另选择同期住院的无高胆红素血症患儿34例作为对照组,高胆红素血症组于入院第1天和治疗后第7天采血,对照组于入院第1天采血,检测并比较各组新生儿血清胆红素、胱抑素C、肌酐和尿素氮的水平.结果 入院第1天,轻度组、中度组和重度组患儿的血清胱抑素C水平和胆红素水平均明显高于对照组,差异有统计学意义(P＜0.05),且高胆红素血症患儿的血清胱抑素C水平与血清胆红素水平呈正相关性(r2=0.596,P＜0.05),4组新生儿的血清肌酐水平和尿素氮水平相比,差异均无统计学意义(P＞0.05).治疗后轻度组、中度组和重度组患儿的血清胆红素水平和胱抑素C水平与治疗前相比均明显降低,差异有统计学意义(P＜0.05),且轻度组和中度组患儿治疗后,血清胆红素和胱抑素C水平略高于对照组,但差异无统计学意义(P＞0.05), 而重度组患儿治疗后,血清胆红素水平和胱抑素C水平与对照组相比,差异均有统计学意义(P＜0.05).结论 高胆红素血症可引起新生儿肾脏功能损伤,且肾脏损伤程度与胆红素水平呈正相关,检测高胆红素血症新生儿血清胱抑素C水平,有利于早期发现患儿的肾脏功能损害,对指导临床治疗有重要的临床意义.%Objective To analyze the clinical significance of serum cystatin C in neonates with hyperbilirubinemia. Methods A total of 95 neonates with hyperbilirubinemia were enrolled in the Department of Neonatology from October 2016 to May 2017. They were divided into mild, moderate and severe groups according to serum bilirubin levels. In the same period, 34 healthy neonates without hyperbilirubinemia from our department were enrolled as controls. The blood samples in hyperbilirubinemia group were collected on the first day of admission and the 7 th day after treatment, while they were collected on the first day of admission in control group. The levels of serum bilirubin, cystatin C, creatinine and urea nitrogen in neonates were measured and compared. Results The levels of serum Cys C and bilirubin in the mild, moderate and severe groups were significantly higher than those in the control group on the first day of admission (P＜0.05). There was a significantly positive correlation between serum Cys C level and serum bilirubin level (r2=0.596, P＜0.05). There was no significant difference in serum creatinine level or urea nitrogen level among the four groups (P＞0.05). The levels of serum bilirubin and Cys C after treatment in mild, moderate and severe groups were significantly lower than those before treatment (P＜0.05). The serum levels of serum bilirubin and Cys C were slightly higher than those in the control group (P＞0.05), and the levels of serum bilirubin and Cys C were significantly higher in the mild and moderate group compared with the control group (P＜0.05). Conclusion Hyperbilirubinemia can induce neonatal renal injury, and the degree of renal injury is positively correlated with the level of bilirubin. The serum Cys C level in neonates with hyperbilirubinemia is helpful for early detection of renal function damage, thus to guide clinical treatment.