Early Diagnostic Value Of Serum Cystatin C For Renal Function Impairment Induced By Neonate Asphyxia

Objective Cystatin C(Cys C) has been regarded as a sensitive marker of early renal function impairment.The purpose of this study is to evaluate the diagnostic value of serum Cys C(SCys C) for renal function impairment induced by neonatal asphyxia.Methods The serum Cys C,Cr and BUN concentrations were measured in 38 asphyxiated newborns (20 mildly asphyxiated newborns,18 seriously asphyxiated newborns) within 3 days after birth.20 cases had no perinatal asphyxia and other factors which could result in renal function impairment were served as control group.And estimate glomerular filtration rate (eGFR) were calculated by Schwartz formula.The level of SCys C,SCr,BUN and eGFR were compared between each group.Receiver operating characteristic (ROC) of SCys C and SCr were made based on eGFR.The area under the Receiver operating characteristic (AUC) and optimun sensitivity,specificity,predictive values were evaluated.Results①The average value of SCys C is 1.19±0.27mg/L,and SCr is 63.4±9.47umol/L, eGFR is 32.1±4.94 mL/min/1.73m2,BUN is 3.85±1.45mmol/L,in control group.②Compared with the control group,the concentration of SCys C,SCr and eGFR in mildly and seriously asphyxiated newborns have significant difference (P﹤0.05);The level of SCys C,SCr and eGFR in seriously asphyxited newborns are significantly higher than that in control group(P﹤0.01);The level of BUN have no significant difference amomg three groups.③The abnormal detection rate of SCys C and SCr are 5% and 25% ,respectively,in mildly asphyxiated newborns;55.6% and 61.1% respectively in seriously asphyxited newborns;there are no significant difference between both groups(P﹥0.05).④The area under ROC curve (AUC) are 0.912 for SCys C,0.930 for SCr.There are no significant difference between SCys C and SCr(P﹥0.05).⑤Based on the average value of eGFR in control group, renal function impairmen is present in 16 of 38 (42.1%) asphyxiated newborns,and 10 of 18 (55.6%) seriously asphyxiated newborns.Conclusion①This study suggests that SCys C appears to be equivalent in sensitivity and reliability to SCr as a marker of GFR in the asphyxiated newborn.The combined measure of SCys C and SCr is important to monitoring the early change of glomerular rate.②The renal function impairment easily occured to asphyxiated newborns,and severity of renal function abnormality correlates well with degree of asphyxia.