关键词: 新生儿窒息, 肾功能损伤, 血清胱抑素C, β2-微球蛋白, 诊断价值

Abstract:

Objective To explore the value of serum cystatin C (CysC) and β2- microglobulin (β2-MG) in early diagnosis of renal function impairment after neonatal asphyxia. Methods Fifty four newborns clinically clearly diagnosed as asphyxia were enrolled, early asphyxia neonates with renal function impairment (immediately admitted to the hospital) and asphyxia neonates combined with Renal function impairment (5 days after treatment) were included in the case group (n=24), and uncombined asphyxiated newborns with impaired renal function were combined in the control group(n=30). Latex particle enhanced immunoturbidimetry, scattering rate turbidimetry, urease-glutamate dehydrogenase method and sarcosine oxidase method were applied to detect the level of CysC, β2-MG, urea nitrogen(BUN) and creatinine(Cr) respectively; the t test was applied to compare the difference in above detection indicators between the case group and the control group. The sensitivity, specificity and the area under the receiver operating characteristic curve (ROC) of indexes in the renal function impairment after neonatal asphyxia were observed, Z test was applied to determine the difference of the area under the different ROC curve.Results The CysC and β2-MG level of newborns in the case group were the highest at admission, and the CysC and β2-MG level of newborns in the control group were the lowest. The index levels in the case group after 5 days of treatment were in intermediate, and the difference was statistically significant (P<0.05). The sensitivity, specificity, and area under the ROC curve of CysC and β2-MG under separate and combined diagnosis were 62.9%, 70.3%, 74.1%, 70.0%, 75.0%, 76.0%, 0.668, 0.692, 0.704, respectively. The Z test indicated that the combined diagnosis on CysC and β2-MG delivered higher diagnostic capacity compared with a single index, and the differences were statistically significant (P<0.05). Conclusion The level of CysC and β2-MG in children with renal function impairment after neonatal asphyxia is higher in the early stage of the disease, and it delivers great significance for the early diagnosis on such disease. The combined detection on CysC and β2-MG honor great diagnostic capaity for renal function impairment after neonatal asphyxia.

Key words: neonatal asphyxia, renal function impairment, CysC, β2-MG, diagnostic value