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【目的】探讨载脂蛋白H(apolipoprotein H,apoH)在新生儿肾小管损害早期诊断意义。【方法】观察60例可能伴早期肾小管功能损害新生儿在入院48 h内分别同时检测外周血单个核细胞apoH基因表达、血肌酐和尿素氮与尿N-乙酰-β-D-氨基葡萄糖苷酶(N-acetyl-beta-D-Glucosaminidase,NAG)活性及尿常规两次,两次间隔12~24 h。【结果】60例新生儿中第一次尿NAG异常83.3%,apoH阳性率为73.3%,第二次尿NAG异常占68.3%,apoH阳性占70.0%,两者比较差异无显著性(P>0.05)。而apoH异常发生率与血尿素氮比较第一次增高非常显著(P<0.01),第二次增高明显(P<0.05);然而,apoH表达两次异常率同血肌酐异常率比较增高均非常显著(P<0.01)。【结论】新生儿肾小管功能损害早期apoH基因表达敏感性与尿NAG酶的诊断价值相同。apoH基因表达比血肌酐和尿素氮在肾功能损害早期更敏感,可作为肾小管损害早期诊断指标。
【Objective】 To investigate the significance of apolipoprotein H (apoH) in the early diagnosis of renal tubular damage in neonates. 【Methods】 A total of 60 newborn infants with early renal tubular dysfunction were observed for the detection of apoH gene expression in peripheral blood mononuclear cells, serum creatinine and urea nitrogen and urine N-acetyl-β-D-glucosaminide N-acetyl-beta-D-Glucosaminidase (NAG) activity and urine routine twice, twice between 12 ~ 24 h. 【Results】 The results showed that the first urinary NAG abnormality was 83.3%, the apoH positive rate was 73.3%, the second urinary NAG abnormality was 68.3%, and the apoH positive rate was 70.0%. There was no significant difference between the two groups (P> 0.05). However, the abnormal incidence of apoH was significantly higher than that of blood urea nitrogen for the first time (P <0.01), and increased for the second time (P <0.05). However, both the abnormal rate of apoH expression and the abnormal rate of serum creatinine were significantly increased Significant (P <0.01). 【Conclusion】 The sensitivity of early apoH gene expression in neonate with renal tubular dysfunction is the same as the diagnostic value of urinary NAG enzyme. ApoH gene expression than serum creatinine and urea nitrogen in early renal damage more sensitive, can be used as an early indicator of renal tubular damage.