围产期早产儿尿蛋白动态变化

Dynamic Changes of Urinary Protein in Premature Infants During the Perinatal Period

摘要:

目的：研究早产儿肾功能特点及与胎龄、日龄的关系。方法：利用免疫比浊法、速率法及ELISA法，测定28～31周组(Ⅰ组)、32～34周组(Ⅱ组)、35～37周组(Ⅲ组)早产儿生后第1天、第4天、第7天尿微量白蛋白(mAlb)、视黄醇结合蛋白(RBP)、N-乙酰-β-D氨基葡萄糖苷酶(NAG)值。结果：同一胎龄段尿mAlb随着日龄增加有下降趋势，但差异无显著性(P>0.05)；同一日龄mAlb随胎龄增加而降低，差异有显著性(P<0.05 或 0.01)。尿RBP，NAG在Ⅰ组和Ⅲ组随日龄增加而增加，在生后第4天形成峰值，而后明显下降，尤以Ⅰ组不同日龄间RBP和NAG差异有显著性(P<0.01 或 0.05)。同一日龄尿RBP，NAG随胎龄增加而明显降低，尤以生后第4天和第7天不同胎龄间RBP和NAG差异有显著性(P<0.05 或 0.01)。结论： 早产儿肾小球、肾小管尚在发育中，受胎龄日龄影响较大。

Abstract:

OBJECTIVE: To explore the characteristics of renal function in relation to gestational age and postnatal day in premature infants. METHODS: Urinary microalbumin (mAlb), retionl binding protein (RBP) and N acetylbeta D glucosceminidase (NAG) concentrations were detected using the immunerurbidinetric method, ELISA method and rate method on the first day, fourth day and seventh day after birth in premature infants. The premature infants were divided into three groups in terms of gestational age: Group Ⅰ: 28～31 weeks; Group Ⅱ: 32～34 weeks; Group Ⅲ: 35～37 weeks. RESULTS: Within the same gestational age of the premature infants, the mAlb concentration showed a decreasing trend following increased postnatal day, but there was no statistical difference. The mAlb concentration in the premature infants of the same postnatal day decreased significantly as the gestational age increased in the three groups (P< 0.01 or 0.05 ). In Group Ⅰ and Group Ⅲ, the concentrations of RBP and NAG elevated with the increase of postnatal day and reached a peak on the fourth day, and decreased then significantly. In the premature infants of the same postnatal day, the changes of urinary RBP and NAG were the same as mAlb, decreasing significantly with the increase of gestational age, and there was a significant difference in the concentrations of RBP and NAG between the three groups (P< 0.01 or 0.05 ). CONCLUSIONS: The stature of glomerulus and renal tubules in premature infants is affected by gestational age and postnatal day.