探讨血清胱抑素C(Cys-C)的变化,β2-微球蛋白(β2-MG),尿中性粒细胞明胶酶相关脂质运载蛋白(NGAL),窒息新生儿的α1-微球蛋白(α1-MG),探讨多种生物标志物联合检测在窒息新生儿急性肾损伤(AKI)早期诊断中的价值。
共纳入110例足月窒息新生儿和30例健康新生儿。将窒息新生儿分为AKI组和非AKI组。血清Cys-C,β2-MG,尿液NGAL,出生后24h测量α1-MG。使用受试者工作特征(ROC)曲线确定生物标志物的诊断价值。
对照组血清肌酐和血尿素氮无显著差异,中度窒息组,重度窒息组在出生后24h。在血清Cys-C方面观察到显著差异,β2-MG,尿NGAL,和α1-MG在3组中。此外,随着窒息的加重,以上指标逐步上升。AKI组和非AKI组4项指标差异有统计学意义(p<0.05)。上述指标的ROC曲线下面积分别为0.670、0.689、0.865、0.617(p<0.05)。4项指标联合诊断新生儿窒息性AKI的敏感性和特异性分别为0.974和0.506。
血清Cys-C,β2-MG,尿液NGAL,α1-MG是诊断新生儿窒息后肾损伤的早期特异性指标。这些参数的联合检测可以帮助临床评估窒息新生儿的肾损伤。
To investigate the changes of serum cystatin C (Cys-C), beta 2-microglobulin (β2-MG), urinary neutrophil gelatinase-associated lipocalin (NGAL), and alpha 1-microglobulin (α1-MG) in asphyxiated neonates, and to evaluate the value of combined detection of multiple biomarkers in the early diagnosis of acute kidney injury (AKI) in asphyxiated neonates.
A total of 110 full-term asphyxiated and 30 healthy neonates were included. The asphyxia neonates were divided into AKI and non-AKI groups. Serum Cys-C, β2-MG, urine NGAL, and α1-MG were measured 24 h after birth. The diagnostic value of the biomarkers was determined using receiver operating characteristic (ROC) curves.
There was no significant difference in serum creatinine and blood urea nitrogen among the control group, moderate asphyxia group, and severe asphyxia group at 24 h after birth. Significant differences were noticed in terms of serum Cys-C, β2-MG, urinary NGAL, and α1-MG among the 3 groups. Moreover, with the aggravation of asphyxia, the above indicators gradually increased. There were significant differences in the 4 indicators between the AKI and non-AKI groups (p < 0.05). The area under the ROC curve of the above indicators was 0.670, 0.689, 0.865, and 0.617, respectively (p < 0.05). The sensitivity and specificity of the combined diagnosis of asphyxia neonatorum AKI with the 4 indicators were 0.974 and 0.506, respectively.
Serum Cys-C, β2-MG, urine NGAL, and α1-MG are early specific indicators for the diagnosis of renal injury after neonatal asphyxia. Combined detection of these parameters could aid clinical evaluation of renal injury in asphyxiated neonates.