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目的探讨血、尿β2-微球蛋白(β2-MG)对新生儿高疸红素血症患儿早期肾功能损害的变化和意义。方法采用反射比浊法测定62例新生儿高疸红素血症患儿(研究组)及23例正常足月新生儿(对照组)的血、尿β2-MG含量水平进行检测。结果高疸红素血症患儿血、尿β2-MG含量与血清胆红素含量之间有一定的依从关系(r血=0.529,P<0.01,r尿=0.359,P<0.01)。当血疸红素水平在91-205μmol/L时,血β2-MG的含量比正常对照组升高,差别有显著意义(P<0.5),而尿β2-MG较对照组,稍高(P>0.05)无显著意义。当血清胆红素在205.2-256.5μmol/L时,血、尿β2-微球蛋白(β2-MG)含量均较对照组明显升高(P<0.05),当血清总胆红素≥256.5μmol/L时血、尿β2-微球蛋白(β2-MG)的含量较对照组显著升高(P<0.001)。结论新生儿高疸红素血症患儿早期存在肾功能损害,检测血、尿β2-微球蛋白(β2-MG)的浓度是观察肾小球滤过和肾小管重吸收功能的特异性指标,但血β2-微球蛋白(β2-MG)更能早期敏感地判断新生儿黄疸时对肾脏的损害。
Objective To investigate the changes and clinical significance of blood and urinary β2-microglobulin (β2-MG) on early renal dysfunction in neonates with jaundice. Methods The level of β2-MG in blood and urine of 62 infants with neonatal jaundice (study group) and 23 normal term newborns (control group) were measured by reflectance turbidimetry. Results There was a certain relationship between blood and urinary β2-MG levels and serum bilirubin level in children with hyperbilirubinemia (r = 0.529, P <0.01, r = 0.359, P <0.01). When blood bilirubin level was 91-205μmol / L, the content of β2-MG in blood was higher than that in normal control group (P <0.5), while urinary β2-MG level was slightly higher than that in control group > 0.05) no significant significance. When serum bilirubin was 205.2-256.5μmol / L, blood and urine β2-microglobulin (β2-MG) levels were significantly higher than those in the control group (P <0.05). When serum total bilirubin was ≥256.5μmol / L blood, urine β2-microglobulin (β2-MG) levels were significantly higher than the control group (P <0.001). Conclusion Neonatal jaundice in children with early childhood dysfunction of renal dysfunction, detection of blood and urine β2-microglobulin (β2-MG) concentration is to observe the glomerular filtration and tubular reabsorption of specific indicators, but Blood β2-microglobulin (β2-MG) more early and sensitive to determine when neonatal jaundice damage to the kidneys.