摘要
目的:分析尿素氮(BUN)、肌酐(SCr)和胱抑素 c(CysC)对足月窒息新生儿发生急性肾损伤(AKI)的预测价值.方法:回顾性收集2020 年1 月至2023 年 6 月 85 例于我院分娩的足月窒息新生儿的临床资料,根据新生儿是否发生AKI分为AKI组(n=30)与非AKI组(n=55).收集两组新生儿性别、胎龄等临床资料及BUN、SCr和CysC等资料并比较,采用 Logistic 多因素回归分析明确影响足月窒息新生儿发生AKI的危险因素,并采用受试者工作特征(ROC)曲线分析 BUN、SCr 和 CysC 对足月窒息新生儿发生AKI的预测价值.结果:两组新生儿性别、胎龄、出生体质量、分娩方式及胎数差异无统计学意义(P>0.05);AKI组新生儿重度窒息比例、BUN、SCr、CysC水平同非AKI组相比较均更高(P<0.05);经Logistic回归分析显示,窒息程度越严重及BUN、SCr、CysC水平异常升高均为预测足月窒息新生儿发生AKI的独立因素(P<0.05);经 ROC 曲线分析显示,血 BUN、SCr、CysC 对足月窒息新生儿发生AKI均有一定预测价值,其中血CysC 预测足月窒息新生儿发生 AKI 的曲线下面积(AUC)及敏感度较血BUN、SCr高,预测价值相对最好(P<0.05).结论:BUN、SCr、CysC 水平检测对于足月窒息新生儿是否发生AKI均具有重用指导价值,且以血清CysC指导价值最好.
Abstract
Objective:To analyze the predictive value of blood urea nitrogen(BUN),serum creatinine(SCr),and cystatin C(CysC)for acute kidney injury(AKI)in asphyxiated full-term neonates.Methods:The clinical data of 85 asphyxiated full-term neonates born in the hospital from January 2020 to June 2023 were collected retrospectively.According to the presence or absence of AKI,neonates selected were divided into the AKI group(n=30)and the non-AKI group(n=55).The clinical data,BUN,SCr,and CysC of the two groups were compared.Multivariate logistic regression analysis was performed to identify the risk fac-tors for AKI in asphyxiated full-term neonates.The receiver operating characteristic(ROC)curves were used to analyze the predictive value of BUN,SCr,and CysC for AKI in asphyxiated full-term neonates.Results:There was no statistically significant difference in gender,gestational age,birth weight,delivery mode,or number of births between the two groups(P>0.05).The proportion of severe asphyxia and the levels of BUN,SCr,and CysC in the AKI group were higher than those in the non-AKI group(P<0.05).Logistic re-gression analysis found that severe asphyxia and abnormally elevated levels of BUN,SCr and CysC were inde-pendent factors in predicting the development of AKI in term neonates with asphyxia(P<0.05).ROC curves indicated that BUN,SCr,and CysC had certain predictive values for AKI in asphyxiated full-term neonates.Among them,the area under the curve(AUC)and sensitivity of CysC were higher than those of BUN and SCr(P<0.05).Conclusion:BUN,SCr,and CysC level tests are of relevance in guiding the development of AKI in full-term asphyxiated neonates,and serum CysC has the best guiding value.
基金项目
2024年大学生创新创业训练计划项目(S202411840078)
陕西省卫健委课题(2022E029)
西安医学院第二附属医院课题(22KY0112)
国家科技期刊平台
NSTL
万方数据