前白蛋白及视黄醇结合蛋白对不同窒息程度新生儿肝功能损害的诊断意义

Diagnostic values of prealbumin and retinol-binding protein for liver damage caused by different degrees of neonatal asphyxia

摘要:

目的 探究前白蛋白 （PAB）及视黄醇结合蛋白 （RBP）对于鉴别轻、重度窒息新生儿的肝损害诊断价值。方法 回顾性分析185例窒息新生儿，依据Apgar评分，分为轻度和重度窒息组，对不同窒息程度早产儿 （84例）、足月儿 （101例）的PAB、RBP、谷丙转氨酶、谷草转氨酶进行比较，并进行ROC曲线分析。结果 与轻度窒息组比较，重度窒息组早产儿的谷草转氨酶较高，PAB、RBP较低 （P < 0.05）；重度窒息组足月儿的PAB较低 （P < 0.05）。与治疗前比，治疗后早产儿重度窒息组的PAB，足月儿轻度窒息组的AST、PAB和重度窒息组的PAB均明显好转 （P < 0.05）。ROC曲线显示，前白蛋白对于窒息足月儿、早产儿肝功能损害评价均有较好的灵敏度及特异度。结论 前白蛋白可作为评价新生儿窒息肝损害的指标，并可以用于判断窒息程度的不同。

Abstract:

Objective To investigate the diagnostic values of prealbumin (PAB) and retinol-binding protein (RBP) for liver damage caused by mild or severe asphyxia. Methods A retrospective analysis was performed on 185 neonates (including 84 premature infants and 101 full-term infants) with asphyxia. Based on the Apgar score, they were divided into two groups:mild asphyxia group (n=150) and severe asphyxia group (n=35). The levels of PAB, RBP, alanine aminotransferase (ALT), and aspartate aminotransferase (AST) were measured and compared. Their diagnostic values for liver damage were evaluated by ROC curve analysis. Results The premature infants in the severe asphyxia group had significantly higher AST level and significantly lower levels of PAB and RBP than those in the mild asphyxia group (P < 0.05). The full-term infants in the severe asphyxia group had a significantly lower PAB level than those in the mild asphyxia group (P < 0.05). After treatment, the PAB level was significantly improved in the premature infants in the severe asphyxia group and in the full-term infants in both mild and severe asphyxia group (P < 0.05). The full-term infants in the mild asphyxia groups also showed a significant improvement in AST level (P < 0.05). The ROC curve analysis showed that PAB had a good sensitivity and specificity for identifying liver damage caused by mild or severe asphyxia in full-term and preterm infants. Conclusions PAB can be used as an indicator of liver damage caused by asphyxia in neonates, and can be used to assess the degree of asphyxia.