【摘 要】
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目的:探讨高胆红素血症对早期新生儿肾功能指标的影响。方法:选择2019年9月至2020年3月徐州市中心医院新生儿科收治的胎龄≥35周且日龄≤7 d的新生儿进行前瞻性队列研究。按
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目的:探讨高胆红素血症对早期新生儿肾功能指标的影响。方法:选择2019年9月至2020年3月徐州市中心医院新生儿科收治的胎龄≥35周且日龄≤7 d的新生儿进行前瞻性队列研究。按照血清总胆红素水平分为轻度组、中度组及重度组。记录患儿一般资料及尿量，测定入组后及光疗后血清总胆红素、血肌酐、血胱抑素C、血中性粒细胞明胶酶相关脂质运载蛋白（neutrophil gelatinase-associated lipocalin，NGAL）、尿NGAL和肾损伤分子1。比较不同程度高胆红素血症对上述肾功能指标的影响。结果:最终纳入轻度组53例、中度组52例和重度组49例。重度组尿NGAL高于中度组及轻度组［（1.36±0.24）μg/L比（1.22±0.19）μg/L、（1.16±0.19）μg/L］，差异有统计学意义（n P0.05）。3组之间其他肾功能指标差异均无统计学意义（n P>0.05）。光疗后重度组尿NGAL明显下降［（1.17±0.28）μg/L比（1.35±0.23）μg/L］，差异有统计学意义（n P0.05). A significantly reduction of urine NGAL level after phototherapy was found [(1.17±0.28) μg/L vs. (1.35±0.23) μg/L,n P<0.001] in the severe group. The level of urine NGAL had positive correlation with serum total bilirubin (n r=0.575,n P<0.001). Neither serum creatinine nor urine volume of all the cases met the diagnostic criteria of neonatal acute kidney injury.n Conclusion:Severe hyperbilirubinemia may temporarily impair the renal tubular reabsorption function of full-term and near-term early neonates, which is probably reversible. However, it has little impact on glomerular filtration function.
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