小于胎龄儿生后早期肾脏功能初探

A preliminary study of renal function in small-for-gestational-age infants at early stage after birth

摘要:

目的 对小于胎龄儿（SGA）生后早期肾脏功能进行回顾性对照研究，以探寻SGA儿早期肾功能损害的诊断方法。方法 选择早产SGA儿40例、足月SGA儿33例作为研究组，并以早产适于胎龄儿（AGA）80例、足月儿AGA 33例作为对照组。比较各组入院48 h内血清尿素氮（BUN）、血清肌酐（SCr）、估算肾小球滤过率（eGFR）、血压、单位体重尿量以及蛋白尿的发生情况。结果 早产儿SGA组的BUN低于AGA组（P < 0.05），两组间SCr、eGFR、血压的差异无统计学意义（P > 0.05）。与足月儿AGA组比较，SGA组的SCr较高、eGFR较低，差异均有统计学意义（P < 0.05）；两组间BUN、血压的差异无统计学意义（P > 0.05）。早产儿或足月儿AGA与SGA之间单位体重尿量的差异无统计学意义（P > 0.05）。早产儿AGA与SGA之间蛋白尿发生率的差异无统计学意义（P > 0.05），足月儿AGA与SGA组均无蛋白尿发生。结论 SCr、eGFR对评估SGA早期肾脏损害较为敏感。足月儿SGA较AGA肾脏功能减低。

Abstract:

Objective To investigate the renal function of small-for-gestational-age (SGA) infants at the early stage after birth. Methods A total of 40 preterm SGA infants, 33 full-term SGA infants, 80 preterm appropriate-forgestational-age (AGA) infants, and 33 full-term AGA infants were included in this study. The following indices were compared between the SGA infants and AGA infants within 48 hours after admission:blood urea nitrogen (BUN), serum creatinine (SCr), estimated glomerular filtration rate (eGFR), blood pressure, urine volume per body weight, and proteinuria. Results The preterm SGA group had a significantly lower BUN level than the preterm AGA group (P < 0.05). However, there were no significant differences in SCr level, eGFR, and blood pressure between the two groups (P > 0.05). The full-term SGA group had a significantly higher SCr level and a significantly lower eGFR than the full-term AGA group (P < 0.05). However, there were no significant differences in BUN level and blood pressure between the two groups (P > 0.05). There was no significant difference in urine volume per body weight between the preterm SGA and preterm AGA groups (P > 0.05) and between the full-term SGA and full-term AGA groups (P > 0.05). There was no significant difference in the incidence of proteinuria between the preterm SGA and preterm AGA groups (P > 0.05). Proteinuria was not present in the SGA full-term and AGA full-term groups. Conclusions SCr and eGFR can be used as the diagnostic indices for early renal damage of SGA infants. The renal function is worse in full-term SGA infants than in full-term AGA infants.