高肾负荷人工配制乳液喂养新生儿及婴儿的肾功能调查及临床研究.DOCVIP

临床医学论文-高肾负荷人工配制乳液喂养新生儿及婴儿的肾功能调查及临床研究 ??????????????????????? 作者：杜志敏，王耀华，黎薇，马增煌，章一，王节梅，林智，邝鹏，邱国新，王若翔 【关键词】? 乳液肾负荷；人工配制乳液；肾功能；尿液微量白蛋白；尿液视黄醇结合蛋白 　　［摘要］ 目的：观察乳液肾负荷(renal solute load,RSL)与新生儿、婴儿(下称乳婴儿)尿液微量白蛋白(urinary microalbumin,mAIb)、视黄醇结合蛋白(urinary retinolbinding protein,RBP)的相关性，探讨高RSL人工配制乳液(下称人工配乳)喂养乳婴儿对肾脏的影响。方法：用双缩脲法测定乳液蛋白质(protein,Pro)，用电极法测定乳液电解质(Na+、K＋、Cl－、Ca2+)；以推算乳液RSL。用免疫散射比浊法测定mAIb，用酶标免疫吸附分析法(enzyme linked immunosorbent assay,ELISA)测定RBP，用冰点法测定血浆渗透压，用苦味酸法测定尿液肌酐(creatinine,Cr)；尿液mAIb浓度以mAIb/Cr比值(UmAIb/UCr)表示，尿液RBP浓度以RBP/Cr比值(URBP/UCr)表示。结果：RSL≥231.79 mOsm/L为高RSL人工配乳。母乳喂养健康组与人工配乳喂养健康组，其乳液RSL差异有显著性(P＜0.01)；UmAIb/UCr、URBP/UCr差异无显著性(P＞0.05)。母乳喂养健康组与住院组、人工配乳喂养健康组与非高RSL人工配乳喂养住院组的乳液RSL、UmAIb/UCr、URBP/UCr差异均无显著性(P＞0.05)，且乳液RSL与UmAIb/UCr、与URBP/UCr均无相关性(P＞0.05)。高RSL人工配乳喂养住院乳婴儿的乳液RSL、UmAIb/UCr、URBP/UCr与非高RSL人工配乳所喂养住院组均差异有显著性(P＜0.01)；高RSL人工配乳喂养住院乳婴儿肾外性失水增加组与肾外性失水不增加组，其乳液RSL差异无显著性(P＞0.05)，UmAIb/UCr、URBP/UCr差异有显著性(P＜0.01)。高RSL人工配乳的乳液RSL值与对应喂养乳婴儿的UmAIb/UCr、URBP/UCr、血浆渗透压三者指标均呈正相关(P＜0.01)。结论：用高RSL人工配乳喂养乳婴儿可影响其肾功能，应引起人工哺乳者及临床的高度重视。 　　［关键词］ 乳液肾负荷；人工配制乳液；肾功能；尿液微量白蛋白；尿液视黄醇结合蛋白 　　Evaluation of the Renal Function of the Newborn and Infant Fed by the Artificial Prepared Galact of High RSL 　　Abstract：Objective To observe the correlation between galact renal solute load (RSL) and urinary microalbumin (mAIb),urinary retinolbinding protein (RBP) in newborns and infants,the influence on the renal function of the newborns and infants fed on artificial prepared galact of high RSL.Methods The galactic protein measured by biuret method and galacticel ectrolyte(Na+、K＋、Cl－、Ca2+) by electrode method,to calculate galactic RSL with both of them.Urinary mAIb measured by nephlometry immunoassay and urinary RBP by enzyme linked immunosorben assay(ELISA),plasmatic osmolality by cryoscopic method,urinary creatinine (Cr) by trinitrophenal method.UmAIb/UCr represented the concentration of urinary mAIb and URBP/UCr of urinary RBP.Results The high RSL artificial prepared galactic RSL ≥231.79 mOsm/L.Betwe