新生儿肾功能损害早期单个核细胞载脂蛋白H基因表达与尿NAG RBP结果比较

Value of blood apoH gene expression and urinary NAG and RBP in early diagnosis of renal function damage in neonates

摘要:

目的：探讨尿N-乙酰-β-D-氨基葡萄糖苷酶（NAG）、视黄醇结合蛋白（RBP）及血载脂蛋白H（apoH）基因表达在新生儿肾功能损害早期诊断中的价值。方法：对60例可能伴肾功能损害的新生儿在入院48 h内分别检测外周血单个核细胞apoH基因表达、肌酐和尿素氮与尿NAG酶活性、RBP及尿常规两次, 两次间隔12~24 h。结果：60例新生儿中第1次尿NAG异常率83.3%，RBP异常率76.7%，apoH阳性率为73.3%；第2次尿NAG，RBP及apoH异常率分别为66.7%，76.7%，70.0%。以上3个指标第1次及第2次异常率比较，差异均无显著性意义（P＞0.05）。但3个指标同血尿素氮和肌酐异常率比较，除第2次尿NAG与血尿素氮异常率比较差异无显著性意义外，其他均显著或极显著高于血尿素氮和肌酐异常发生率。结论：新生儿肾功能损害早期尿RBP和血apoH基因表达与NAG酶的诊断价值相同。血apoH基因表达和尿NAG及RBP较血肌酐和尿素氮在肾小管损害早期更敏感。［中国当代儿科杂志，2009，11（8）：649-652］

Abstract:

OBJECTIVE: To study the value of apolipoprotein H (apoH) gene expression in peripheral blood mononuclear cell (PBMC) and urinary N-Acetyl-beta-D-Glucosaminidase (NAG) and retinal-binding protein (RBP) in the early diagnosis of renal function damage in neonates. METHODS: Sixty sick neonates who renal function damage probably occurred were enrolled. The blood and urinary samples were collected twice within 48 hrs following admission, with an interval of 12-24 hrs. Expression of apoH gene in PBMC was determined with RT-PCR. The levels of blood urea nitrogen (BUN) and creatinine, and urinary activities of NAG and RBP were measured with enzymatic reaction. RESULTS: The abnormal rates of blood apoH and urinary NAG and RBP were 73.3%, 83.3% and 76.7%, respectively in the first detection. The second detection for blood apoH and urinary NAG and RBP showed abnormal rates of 70.0%, 66.7% and 76.7%, respectively. There were no significant differences in the abnormal rates between the three markers either in the first or the second detection (P>0.05). Beside there were no significant significances in the abnormal rates between urinary NAG and blood BUN in the second detection, the abnormal rates of blood apoH and urinary NAG and RBP in both detections were significantly higher than those of BUN or creatinine (P<0.01 or 0.05). CONCLUSIONS: There are identical values of blood apoH gene expression and urinary NAG and RBP in the early diagnosis of renal function damage in neonates. The above three markers are more sensitive to early renal function damage than blood BUN and creatitine.［Chin J Contemp Pediatr, 2009, 11 (8):649-652］