窒息新生儿尿酶改变及与外周血白细胞计数的关系

Changes of Urinary Enzymes and their Relationship with Peripheral White Cell Count in Postasphyxial Newborns

摘要:

目的 探讨窒息新生儿尿酶改变及其与外周血白细胞计数的关系。方法 28例窒息新生儿，分为轻度窒息组(10例)和重度窒息组(18例)；另外选择9例正常新生儿作对照组，检测各组外周血白细胞计数、尿N乙酰β氨基酸葡萄糖苷酶(NAG)和γ谷胺酰转肽酶(GGT)，比较各组间白细胞计数及其与NAG、GGT的关系。结果 外周血白细胞计数、NAG、GGT重度窒息组分别为(27.42±10.95)×109/L，(34.28±26.18) U/L，(30.50±21.10) U/L，轻度窒息组分别为(10.24±4.10)×109/L，(10.34±8.72) U/L，(16.80±6.48) U/L，对照组分别为(15.70±3.21)×109/L，(2.73±2.50) U/L，(8.75±2.43) U/L。重度窒息组与轻度窒息组和对照组比较，外周血白细胞计数、NAG、GGT均显著升高(P<0.05)。轻度窒息组与正常组比较，除外周血白细胞计数外，NAG和GGT也显著升高(P<0.05)。直线相关分析显示：重度窒息组外周血白细胞计数与尿NAG呈显著正相关关系(γ=0.41，P<0.05)，与GGT呈正相关关系，但无显著性(P>0.05)。结论 外周血白细胞计数升高与新生儿窒息程度和尿酶升高程度密切相关，在临床上可将外周血白细胞计数作为窒息后肾损伤的预警参数。

Abstract:

Objective To determine the changes of urinary enzymes and the relationship with the peripheral white cell count in po stasphyxial newborns. Methods We divided 28 newborns with asphy xia into 2 groups: mild asphyxia group (10 cases) and severe asphyxia group (18 cases) and 9 normal newborns as controls. The peripheral white cell count, urina ry Nacetyl-β-Dglucosaminidase (NAG), and urinary γglutamy transpeptidase (GGT) were studied within 24 hours of life. Results The peri pheral white cell count and urinary NAG, GGT in the severe asphyxia group were ( 27.42±10.95)×109/L, (34.28±26.18) U/L, (30.50±21.10 ) U/L respectively; those in the mild asphyxia group were (10.24±4.10 )×109/L, (10.34±8.72) U/L, (16.80±6.48) U/L respectively; T hose in the control group were (15.70±3.21)×109/L, (2.73± 2.50) U/L, (8.75±2.43) U/L respectively. The severe asphyxia group wa s higher than those in both the mild asphyxia group and the control group (P<0.05). Except for the peripheral white cell count (P>0.05), NAG and GGT in the mild asphyxia group were higher than those in the control group. The white cell count was positively related to the levels of urinary NAG (r=0.41,P<0.05) and GGT (r=0.22,P>0.05) in the severe as phyxia group. Conclusions The peripheral increased white cell c ount was related to the severity of asphyxia and changes of urinary enzymes, whi ch may be a predicting parameter for postasphyxial renal damage.