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目的探讨不同程度高胆红素血症患儿血清中尿酸、肌酐及胱抑素C的水平变化及其临床意义,为评价新生儿高胆红素血症肾脏损伤提供客观的临床生化指标。方法选择2011年1月至2011年9月广州市妇女儿童医疗中心收治的高胆红素血症(TBil≥220.6μmol/L)新生儿为高胆红素血症组,根据胆红素水平分为轻度(220.6~256.5μmol/L)、中度(256.6~342.2μmol/L)和重度(≥342.2μmol/L)高胆红素血症。同时,选择同期自然分娩、足月无黄疸(日龄1-30 d)的健康新生儿作为对照组。应用常规生物化学方法分析高胆红素血症组和对照组新生儿血清中的尿酸、肌酐及胱抑素C水平,并用SPSS17.0软件对数据进行统计分析。结果高胆红素血症组血清胱抑素C水平高于对照组(P<0.01);高胆红素血症组血清尿酸、肌酐水平与对照组比较差异无统计学意义(P>0.05)。Spearman直线相关分析结果显示,高胆红素血症新生儿的胱抑素C水平与其血清总胆红素呈正相关(r=0.679,P=0.000);尿酸、肌酐与血清总胆红素水平无相关性(P>0.05)。结论胱抑素C是反映高胆红素血症新生儿肾功能水平的重要监测指标,可辅助临床医生及时诊断,及早进行干预治疗。
Objective To investigate the changes of serum uric acid, creatinine and cystatin C in children with different degrees of hyperbilirubinemia and its clinical significance, and to provide objective clinical and biochemical indexes for the evaluation of neonatal hyperbilirubinemia. Methods The neonates with hyperbilirubinemia (TBil≥220.6μmol / L) admitted to Guangzhou Women and Children Medical Center from January 2011 to September 2011 were hyperbilirubinaemia group. According to the level of bilirubin (220.6 ~ 256.5μmol / L), moderate (256.6 ~ 342.2μmol / L) and severe (≥342.2μmol / L) hyperbilirubinemia. At the same time, select the same period of natural childbirth, full-term jaundice (day 1-30 d) of healthy newborns as a control group. The levels of uric acid, creatinine and cystatin C in serum of neonates with hyperbilirubinemia and control groups were analyzed by routine biochemical methods. The data were analyzed by SPSS17.0 software. Results The level of serum cystatin C in hyperbilirubinemia group was higher than that in control group (P <0.01). There was no significant difference in serum uric acid and creatinine between hyperbilirubinemia group and control group (P> 0.05) . Spearman linear correlation analysis showed that the level of cystatin C in neonates with hyperbilirubinemia was positively correlated with serum total bilirubin (r = 0.679, P = 0.000); the level of uric acid, creatinine and total serum bilirubin Correlation (P> 0.05). Conclusion Cystatin C is an important monitoring index of renal function in neonates with hyperbilirubinemia, which can help clinicians timely diagnosis and early intervention.