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[新生儿产后肌红蛋白血液监测。与出生后48小时内肾功能的相关性]

[Postpartum myoglobin blood monitoring in newborns. Correlations with renal function in the first 48 hours of life].

作者信息

Rizzardi R, Castelli S, Porta C, Vitali F, Minerva M, Della Marta M E, Raimondi M

机构信息

Servizio Anestesia e Rianimazione, USSL 58, Ospedale Uboldo, Cernusco SN, (Milano).

出版信息

Minerva Anestesiol. 1997 Apr;63(4):127-31.

PMID:9380286
Abstract

BACKGROUND

Myoglobin is a muscular tissue protein, and it is a very early damage index. As the newborn "thin mass" is less than that of the adult and knowing the renal dynamics of this protein clearance, the authors have analyzed the correlation between myoglobinemia and transitory renal failure, which is frequently present in newborns with fetal distress.

METHODS

We examined a random population of 56 newborns (33 eutocic deliveries 14 caeserotomy, 9 various degrees of fetal distress) to which, after having had the parents' informed consent, the microsamples pattern was fixed at 0, 6, 12, 24, 48 hours from birth at the same time of ordinary exams to gauge: myoglobin with nephelometric method, CPK, creatininemia, azotemia and transaminase. The same exams were camed out on the mother at the beginning of labor and after delivery.

RESULTS

We found that the placenta is not permeable to mother myoglobin, at the sixth hour from birth we have the highest value, while CPK is lower to increase, myoglobinemia associated with myoglobin variations.

CONCLUSIONS

Myoglobinemia might be monitored to prevent distressed newborns from transitory renal tubular defect, justifying forced diuresis and urinary alkalosis.

摘要

背景

肌红蛋白是一种肌肉组织蛋白,是非常早期的损伤指标。由于新生儿“瘦体重”低于成人,且了解该蛋白清除的肾脏动力学,作者分析了肌红蛋白血症与短暂性肾衰竭之间的相关性,短暂性肾衰竭在胎儿窘迫的新生儿中很常见。

方法

我们检查了56名新生儿的随机样本(33例顺产、14例剖宫产、9例不同程度的胎儿窘迫),在获得家长知情同意后,在出生后0、6、12、24、48小时与常规检查同时采集微量样本,以测定:用比浊法测定肌红蛋白、肌酸磷酸激酶、肌酐血症、氮质血症和转氨酶。在分娩开始时和分娩后对母亲进行同样的检查。

结果

我们发现胎盘对母亲的肌红蛋白不具有通透性,出生后第6小时肌红蛋白值最高,而肌酸磷酸激酶升高幅度较小,肌红蛋白血症与肌红蛋白变化相关。

结论

监测肌红蛋白血症可预防窘迫新生儿出现短暂性肾小管缺陷,这为强制利尿和尿液碱化提供了依据。

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