窒息新生儿肾功能损害尿NAG和RBP的变化

Changes of Nacety-β-D-AminoGlucosidase and Urinary Retinal Binding Protein in Newborns with Asphyxia Complicated by Renal Function Impairment

摘要:

目的：探讨窒息新生儿肾功能损害尿N-乙酰-β-D氨基葡萄糖苷酶(NAG)，尿视黄醇结合蛋白(RBP)的变化。方法：采用对硝基苯酚比色法及ELISA测定窒息足月儿、早产儿和正常足月儿、早产儿生后第1，3，7天尿NAG活性和尿RBP含量。结果：重度窒息足月儿、早产儿生后第3，7天尿NAG水平均明显高于对照组(P<0.01)。并以生后第3天升高最明显，重度窒息组显著高于轻度窒息组；而尿RBP水平，窒息足月儿及早产儿第1，3天均明显高于对照组(P<0.01)，第7天仍增高(P<0.05)。窒息新生儿窒息程度越重，其肾功能损害越明显，恢复也越慢。窒息组生后第1天尿RBP即有明显增高，与对照组相比差异有显著性(P<0.01)，而尿NAG差异无显著意义(P>0.05)。结论：尿NAG，RBP可作为早期监测肾功能损害的常规方法，尿RBP是一项较尿NAG更敏感的肾功能损害的早期诊断指标。

Abstract:

OBJECTIVE: To study the changes in Nacety-β-D-amino glucosidase (NAG) and urinary retinal binding protein (RBP) observed after renal function impairment in asphyxiated newborns. METHODS: Colorimetry of p nitrophoenol and ELISA were adopted to detect the activity of NAG and the content of RBP in asphyxiated full term and premature infants on days 1, 3 and 7, and in matched nonasphyxiated control infants. RESULTS: The levels of NAG and RBP were higher in both asphyxiated full term and premature infants than in the control group (P<0.01). The changes were most significant on day 3 after birth, and correlated with the degree of asphyxia. The degree and duration of renal dysfunction also correlated significantly with the degree of asphyxia. Urinary RBP levels in the asphyxiated newborns rose significantly within 1 day after birth compared to the controls (P<0.01), while there was no significant difference in the levels of NAG on day 1 of life in asphyxiated infants (P>0.05). CONCLUSIONS: NAG and RBP appear to be indexes of early diagnosis in renal dysfunction in asphyxiated infants, and RBP is a more sensitive one.