中国综合临床
中國綜閤臨床
중국종합림상
CLINICAL MEDICINE OF CHINA
2010年
3期
251-253
,共3页
高胆红素血症%肾功能%抗氧化剂%新生儿
高膽紅素血癥%腎功能%抗氧化劑%新生兒
고담홍소혈증%신공능%항양화제%신생인
Hyperbilirubinemia%Renal function%Antioxidant%Newbern
目的 探讨新生儿高胆红素血症对肾功能损害机制及早期干预治疗的效果.方法 观察组为100例高胆红素血症的新生儿,在入院24 h内检测血清胆红素、丙二醛(MDA)、血β_2-微球蛋白(β_2-MG)及尿微量蛋白(β_2-MG、α_1-MG、ALB).对照组为50例正常生理性黄疸新生儿.观察组早期给予抗氧化剂(维生素E,还原性谷胱甘肽)及传统干预措施(原发病治疗,蓝光照射,药物疗法),治疗3 d及出院前一天(治疗6 d)复查以上项目.结果 当未结合胆红素在205.0～256.5μmol/L时,尿β_2-MG、α_1-MG,血MDA较对照组升高(P<0.05),当未结合胆红素256.6～342.0βmol/L时,不仅尿β_2-MG、α_1-MG,血MDA升高,而且血β_2-MG升高(P<0.01,P<0.05),当未结合胆红素>342.0 μmol/L时,血β_2-MG、尿ALB明显增高(P<0.01,P<0.05).经早期干预治疗后,血胆红素下降,血β_2-MG、尿微量蛋白基本恢复正常,观察组加抗氧化剂后较对照组恢复更快(P<0.05).结论 高胆红素血症对新生儿肾小球滤过功能及肾小管重吸收功能造成损害;高胆红素对肾脏功能的损害与高未结合胆红素血症诱导的脂质过氧化作用有关,在传统干预治疗基础上加抗氧化剂治疗效果更好.
目的 探討新生兒高膽紅素血癥對腎功能損害機製及早期榦預治療的效果.方法 觀察組為100例高膽紅素血癥的新生兒,在入院24 h內檢測血清膽紅素、丙二醛(MDA)、血β_2-微毬蛋白(β_2-MG)及尿微量蛋白(β_2-MG、α_1-MG、ALB).對照組為50例正常生理性黃疸新生兒.觀察組早期給予抗氧化劑(維生素E,還原性穀胱甘肽)及傳統榦預措施(原髮病治療,藍光照射,藥物療法),治療3 d及齣院前一天(治療6 d)複查以上項目.結果 噹未結閤膽紅素在205.0～256.5μmol/L時,尿β_2-MG、α_1-MG,血MDA較對照組升高(P<0.05),噹未結閤膽紅素256.6～342.0βmol/L時,不僅尿β_2-MG、α_1-MG,血MDA升高,而且血β_2-MG升高(P<0.01,P<0.05),噹未結閤膽紅素>342.0 μmol/L時,血β_2-MG、尿ALB明顯增高(P<0.01,P<0.05).經早期榦預治療後,血膽紅素下降,血β_2-MG、尿微量蛋白基本恢複正常,觀察組加抗氧化劑後較對照組恢複更快(P<0.05).結論 高膽紅素血癥對新生兒腎小毬濾過功能及腎小管重吸收功能造成損害;高膽紅素對腎髒功能的損害與高未結閤膽紅素血癥誘導的脂質過氧化作用有關,在傳統榦預治療基礎上加抗氧化劑治療效果更好.
목적 탐토신생인고담홍소혈증대신공능손해궤제급조기간예치료적효과.방법 관찰조위100례고담홍소혈증적신생인,재입원24 h내검측혈청담홍소、병이철(MDA)、혈β_2-미구단백(β_2-MG)급뇨미량단백(β_2-MG、α_1-MG、ALB).대조조위50례정상생이성황달신생인.관찰조조기급여항양화제(유생소E,환원성곡광감태)급전통간예조시(원발병치료,람광조사,약물요법),치료3 d급출원전일천(치료6 d)복사이상항목.결과 당미결합담홍소재205.0～256.5μmol/L시,뇨β_2-MG、α_1-MG,혈MDA교대조조승고(P<0.05),당미결합담홍소256.6～342.0βmol/L시,불부뇨β_2-MG、α_1-MG,혈MDA승고,이차혈β_2-MG승고(P<0.01,P<0.05),당미결합담홍소>342.0 μmol/L시,혈β_2-MG、뇨ALB명현증고(P<0.01,P<0.05).경조기간예치료후,혈담홍소하강,혈β_2-MG、뇨미량단백기본회복정상,관찰조가항양화제후교대조조회복경쾌(P<0.05).결론 고담홍소혈증대신생인신소구려과공능급신소관중흡수공능조성손해;고담홍소대신장공능적손해여고미결합담홍소혈증유도적지질과양화작용유관,재전통간예치료기출상가항양화제치료효과경호.
Objective To investigate the renal function damage in newberns ruth hyperbilirubinemia and the effects of early treatment. Methods 100 newberns with hyperbilirubinemia were taken as treatment group. Ser-um bilirubin, malondialdehyde (MDA), β_2-MG, and urine-minim protein (β_2-MG, α_1-MG, ALB) were measured within 24 hours after charge in. 50 healthy newborns had been chosen as controls. Anti-oxidate (vitamin E and Glu-tathion) as weel as regular method were given to the treatment group. All the above biochemical indexes were tested in the 3td and 6th day. Results When bilirubin level was in 205.0～256.5 μmol/L, β_2-MG、α_1 -MG in urine and MDA in blood were higher in treatment group than in control group(P < 0.05);when unconjugated bilirubin(UCB) was in in 256.6～342.0 μmol/L, β_2-MG was also raised (P < 0.01, P < 0.05);and when UCB greater than in 342.0 μmol/L, serum β_2-MG and urine ALB raised significantly (P <0.01,P <0.05). After early treatment, bil-irubin decreaed, and, β_2-MG, urine-minim protein declined to normal level, with a faster recovery in treatment group than control group (P < 0.05). Conclusions Hyperbilirubinemia may damage the glomerular filtration and renal tubule's re-absorption function in neonatals. Lipid peroxidation activated by UCB in Hyperbilirubinemia may cause thease damages. Antioxidant combined with regular treatment could lead better results.
