【摘要】 【目的】研究新生儿缺氧缺血性脑病(hypoxic-ischemic encephalopathy,HIE)尿大分子碱性磷酸酶(highmolecular alkaline phosphatase,HMAP)水平的变化,探讨HMAP与新生儿HIE急性肾功能衰竭(acute renal failure,ARF)的关系。【方法】利用抗HMAP的单克隆抗体,免疫催化方法检测30例正常对照组新生儿、44例HIE肾衰组新生儿及48例HIE非肾衰组新生儿不同时期尿HMAP的水平,并同时留尿测定各组β2-微球蛋白(β2-MG)的水平。【结果】发病初期,肾衰组、非肾衰组尿HMAP、β2-MG水平高于恢复期和对照组(P均<0.001),且肾衰组尿HMAP高于非肾衰组(P<0.05);发病初期,肾衰组、非肾衰组HIE新生儿尿HMAP与β2-MG均呈显著正相关(P<0.001)。尿HMAP判断HIE新生儿ARF的敏感性、特异性分别为98.7%、80.0%。【结论】在HIE新生儿ARF病程中尿HMAP呈先上升后下降变化趋势,与肾脏的损害及修复过程密切相关,它能比尿β2-MG更灵敏地早期判断HIE肾损伤及严重程度。更多还原

【Abstract】 【Objective】 To investigate the dynamic changes of urinary high molecular alkaline phosphatase(HMAP) in hypoxic-ischemic encephalopathy(HIE) neonates and their relationship with acute renal failure(ARF). 【Methods】 By using a monoclonal antibody immunocatalytic assay method,the concentrations of urinary HMAP were determined at the different stages in 44 HIE neonates with ARF(ARF group) and 48 HIE neonates without ARF(non-ARF group) and 30 healthy controls.The concentrations of urinary β2-MG in three groups were also determined. 【Results】 The levels of urinary HMAP and β2-MG in ARF group and non-ARF group at the initial stage of the illness were higher than those in control group(P<0.001),and decreased significantly at the recovery stage(P<0.001),which were no differ from control group(P>0.05).The levels of urinary HMAP in ARF group were higher than those in the non-ARF group(P<0.05).Urinary HMAP was positively correlated with β2-MG in ARF group and non-ARF group at the initial stage(P<0.001).The sensitivity and specificity of urinary HMAP to determine ARF were 98.7% and 80% respectively. 【Conclusions】 The levels of urinary HMAP in HIE neonates with ARF showed a changing trend from rising at first to dropping afterwards.The alteration pattern is correlative with the course of renal injury and recovery.Urinary HAMP is a more sensitive diagnostic parameter than urinary β2-MG and may be used for early detection of HIE renal dysfunction and its severity.更多还原