The Observation On Changes Of CysC And β₂-MG Level In Neonate With Unconjugated Hyperbilirubinima And Efeect Of Exchange Transfusion On Renal Function

Objective The purpose of this study was to investigate the change of Cys C and β2-MG level in neonate with unconjugated hyperbilirubinemia and effect of exchange transfusion on renal functionMethod A total of 85 jaundiced term infants who admitted to the Neonatology derpartment of Chenzhou Childern hospital affiliated to Nanhua University.The observation objects were divided into three groups according the level of total serum bilirubin on admission, mild group(220.6≤bilirubin<256umol/L)、moderate group(256≤bilirubin<342umol/L) and severe group(bilirubin≥342umol/L), then divided into phototherapy group and exchange transfusion group according the therapeutic regimen. Infants in Phototherapy group with mild 、 moderate and severe jaundice were subsumed into mild phototherapy group、moderate phototherapy group and severe phototherapy group respectively. The level of serum Cys C、serumβ2-MG、urinary Cys C and urinary β2-MG of the observation objects were measured on day 1、day 4 and day 7 of hospitalization and infants in control group were measured on day 1 only. Differences of these parameters among and with groups were analyzed.Result1 The value of serum Cys C 、serumβ2-MG、urinary Cys C、urinaryβ2-MG level of mild、moderate、severe jaundice group and control group on day 1 of hospitalization were different significantly(P<0.05) and correlated with TBIL level positively(r=0.243~0.721,P<0.05).2 In the comparison of the value of serum Cys C and serumβ2-MG level among mild、moderate and severe phototherapy group on day 1、day 4 and day 7 of hospitalization, there existed interaction in factors of grouping and time influencing using repeated measures analysis of variance(P<0.05), serum Cys C and serumβ2-MG level at different time were significant different(P<0.05) but no different among groups. The level of serum Cys C of severe phototherapy group were different signifantly between any two time point(P<0.05) while level of serumβ2-MG were different between day1 and day 4、day 1 and 7(P<0.05) and presented downward trend while these parameters did not differ significantly in mild and moderate phototherapy group(P>0.05).3 In the comparison of the value of urinary Cys C and urinaryβ2-MG level among mild、moderate and severe phototherapy group on day 1、day 4 and day 7 of hospitalization, there existed interaction in factors of grouping and time influencing using repeated measures analysis of variance(P<0.05), urinary Cys C and urinary β2-MG level were significant different at different time(P<0.05) and different group. The level of urinary Cys C of moderate phototherapy group were different signifantly between any two time point(P<0.05) while level of serumβ2-MG were different between day1 and day 4 、 day 1 and 7(P < 0.05). The parameters of severe phototherapy group were different between any two time point(P<0.05) and presented downward trend over time. Difference among time points in mild phototherapy group did not reach statistical significance(P>0.05).4 In the comparison of the value of serum Cys C and serumβ2-MG level between severe phototherapy and exchange transfusion group on day 1、day 4 and day 7 of hospitalization, there were no interaction in factors of grouping and time influencing using repeated measures analysis of variance(P<0.05), serum Cys C and serumβ2-MG level at different time were significant different(P<0.05) but no different among groups(P>0.05). The level of serum Cys C and serumβ2-MG of the two groups presented downward trend over time and these parameters in exchange transfusion group were different between day1 and day 4、day 1 and 7(P<0.05)5 In the comparison of the value of urinary Cys C and urinaryβ2-MG level between severe phototherapy and exchange transfusion group on day 1、day 4 and day 7 of hospitalization, there were no interaction in factors of grouping and time influencing using repeated measures analysis of variance(P<0.05), urinary Cys C and urinaryβ2-MG level at different time were significant different(P < 0.05), the urinary β2-MG level was different(P<0.05) between severe phototherapy and exchange transfusion group while the urinary Cys C showed no difference between the two groups(P>0.05). The level of urinary Cys C and urinaryβ2-MG presented downward trend in the two groups and parameters in exchange transfusion group were different between any two time point(P<0.05).ConclusionUnconjugated hyperbilirubinemia of newborn could result in kidney injury and exchange transfusion is benefit in improving renal tubule function.