ISSN 1674-3865  CN 21-1569/R
主管：国家卫生健康委员会
主办：中国医师协会
　　　辽宁省基础医学研究所
　　　辽宁中医药大学附属医院
中国中西医结合儿科学

中国中西医结合儿科学 ›› 2021, Vol. 13 ›› Issue (2): 148-.

• 临床研究 • 上一篇    下一篇

中性粒细胞明胶酶相关脂质运载蛋白在新生儿窒息急性肾损伤的早期诊断价值

冯骁，田维敏，陈凌，赵红缨   

  1. 361000 福建 厦门，厦门大学附属中山医院儿科
  • 出版日期:2021-04-25 发布日期:2021-05-18
  • 通讯作者: 陈凌，E-mail：lindachen@189.com
  • 作者简介:冯骁（1984-），男，医学硕士，主治医师。研究方向：儿童肾脏病

The early diagnostic value of neutrophil gelatinase-associated lipocalin in neonatal asphyxia with acute kidney injury

FENG Xiao，TIAN Weimin，CHEN Ling，ZHAO Hongying   

  1. Department of Pediatrics，Zhongshan Hospital Xiamen University，Xiamen 361000，China
  • Online:2021-04-25 Published:2021-05-18

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摘要： 目的:通过检测新生儿窒息急性肾损伤（AKI）患者脐血、血清、尿液中性粒细胞明胶酶相关脂质运载蛋白（NGAL）水平的变化，为临床早期识别新生儿窒息AKI提供依据。
方法:收集2018年1月至2019年12月我院产科出生，新生儿科收治的新生儿窒息的足月儿72例作为研究对象，分别检测脐血NGAL，出生后第1、3天血NGAL、血肌酐、尿NGAL、尿肌酐，根据生后7 d内是否发生AKI，分为AKI组和非AKI组，并分析检测结果。
结果:窒息新生儿中AKI组脐血NGAL水平高于非AKI组，差异有统计学意义（P<0.01）；AKI组生后第1、3天血NGAL、尿NGAL/尿肌酐水平均高于非AKI组，差异均有统计学意义（P<0.01）；AKI组第1天血肌酐水平与非AKI组对比，差异无统计学意义（P>0.05），AKI组生后第3天血肌酐水平高于非AKI组，差异有统计学意义（P<0.01）。脐血、生后第1天外周血、尿NGAL预测窒息后AKI的AUC值分别为0. 83（95％CI 0.74～0.91）、0.90（95％CI 0.86～0.94）、0.81（95％CI 0.67～0.95），当血NGAL临界值取119 μg/L时，对于新生儿窒息后AKI的预测灵敏度为88％，特异度为87％。
结论:脐血NGAL、血NGAL、尿NGAL能够早期、特异性的诊断新生儿窒息AKI，有较高的临床应用价值。

关键词: 新生儿窒息, 急性肾损伤, 中性粒细胞明胶酶相关脂质运载蛋白, 儿童

Abstract: Objective:To detecting the changes of neutrophil gelatinase-associated lipocalin（NGAL） in umbilical cord blood，serum and urine in asphyxiated neonates Acute kidney injury，explore the diagnostic value of NGAL in neonatal asphyxia acute kidney injury.
Methods:72 patients with Asphyxia neonatorum in our hospital from 2018 to 2019 were collect as research objects，Detection the umbilical cord blood after birth.Serum NGAL(sNGAL)，serum creatinine (sCr)，urine NGAL and urine creatinine were measured on the first and third day after birth.According to whether acute renal injury occurs within 7 days after birth，it is divided into acute kidney injury group (AKI group) and non acute kidney injury group (non AKI group) .
Results:The NGAL level of umbilical cord blood in AKI group was higher than that in non AKI group(P<0.01)，The levels of sNGAL and uNGAL/UCR in AKI group were higher than those in non AKI group on the first day after birth(P<0.01)，The levels of sNGAL and uNGAL/UCR in AKI group were higher than those in non AKI group on the third day after birth(P<0.01)，There was no significant difference in the level of sCr between AKI group and non AKI group on the first day(P>0.05)， the level of sCr in AKI group was higher than that in non AKI group in the third day after birth(P<001).The AUC values of umbilical cord blood，serum and urine NGAL in asphyxiated neonates Acute kidney injury were 0.83（95％CI 0.74-0.91）、0.90（95％CI 0.86-0.94）、0.81（95％CI 0.67-0.95），The critical value of serum NGAL concentration was 119 μg/L,and the sensitivity was 88% and the specificity was 87%.
Conclusion:The concentration of umbilical cord blood NGAL，serum NGAL and urine NGAL can reflect the neonatal asphyxia acute kidney injury，which have high clinical application values.

Key words: Neonatal Asphyxia, Acute kidney injury, NGAL, Child