Cys-C预警新生儿缺氧缺血性脑病肾损伤的临床观察

摘要

Objective To explore the clinical signifance of Serum cystatin C( Cys-C )in warning the early neonatal renal injury in neonatal hypoxic ischemic encephalopathy( Hypoxic ischemic encephalopathy, HIE ). Methods 49 cases of newborn infants with hypoxic is-chemic encephalopathy in Huainan First People' s Hospital from September 2011 to September 2012 were selected. Neonatal serum cystatin C( Cys-C ), serum creatinine( SCr )and blood urea nitrogen( BUN )value were measured. Results Serum cystatin C in HIE group was significantly higher than that in control group( P<0.01 );And with the grading increase serum cystatin C value increased gradually( P< 0.05 );they were positively correlated( r =0.580 4,P<0.05 );Serum cystatin C abnormalities occur rence rate was higher than that of blood Cr,BUN,with significant difference( P <0. 05 ). Conclusion Cys-C,compared with SCr,BUN,is more sensitive to reflect the condition of renal function, which has an important clinical value in warning early renal injury of neonatal hypoxic ischemic encephalopathy.%目的 探讨血清胱抑素C(Cys-C)在新生儿缺氧缺血性脑病(Hypoxic Ischemic Encephalopathy,HIE)中预警新生儿肾损伤的临床意义.方法 选择2011年9月-2012年9月在淮南市第一人民医院新生儿科住院49例HIE患儿,入院次日抽空腹血,测定各组新生儿Cys-C、血清肌酐(SCr)和尿素氮(BUN)值.所有HIE的新生儿生后7 d内进行HIE临床分度,分为轻、中、重3组,以同期15例足月正常新生儿为对照组.观察对比HIE各组和对照组的以上指标,并进行相关性分析.结果 HIE各组Cys-C明显高于对照组(P<0.01);且随临床分度的加重Cys-C值逐渐增高(P<0.05);呈正相关(r=0.580 4,P<0.05);Cys-C值异常发生率高于血Cr、BUN,其差异有显著性(P<0.05).结论 Cys-C比SCr,BUN更早,更敏感反映肾功能情况,在新生儿缺氧缺血性脑病中预警肾损伤有重要的临床价值.