内科

目的探讨血清核转录因子-κB(NF-κB)、正肝型脂肪酸结合蛋白(L-FABP)与新生儿窒息Apgar评分的相关性。方法选取2014年7月至2017年7月我院儿科收治的窒息新生儿178例为研究组，根据肾功能损伤情况，将患儿分为急性肾损伤组(AKI组，58例)和非急性肾损伤组(非AKI组，120例)，根据窒息严重程度将AKI患儿分为重度窒息组和轻度窒息组；选取同期在我院产科出生的健康足月新生儿50例作为对照组。检测比较AKI组、非AKI组、对照组小儿NF-κB、L-FABP、血尿素氮（BUN）、血肌酐（Scr）水平及Apgar评分，对窒息患儿NF-κB、L-FABP水平与肾功能、Apgar评分的关系进行Spearman相关分析。结果AKI组患儿NF-κB、L-FABP、BUN、Scr水平均显著高于非AKI组患儿和对照组小儿，1 min Apgar评分显著低于非AKI组患儿和对照组小儿，差异有统计学意义(P＜0.05)；非AKI组患儿NF-κB、L-FABP水平均显著高于对照组小儿，1 min Apgar评分显著低于对照组小儿，差异有统计学意义(P＜0.05)。重度窒息AKI患儿NF-κB、L-FABP、BUN、Scr水平均显著高于轻度窒息AKI患儿，1 min Apgar评分显著低于轻度窒息AKI患儿，差异有统计学意义(P＜0.05)。窒息患儿的NF-κB、L-FABP水平与BUN或Scr水平呈正相关，与1 min Apgar评分呈负相关。NF-κB、L-FABP联合检测诊断窒息新生儿肾损伤的灵敏度、特异度及准确度分别84.4%、90.0%和88.2%。结论窒息新生儿的NF-κB、L-FABP水平与BUN或Scr水平正相关，与1 min Apgar评分呈负相关；联合检测NF-κB和L-FABP水平早期诊断窒息新生儿肾损伤具有较高的准确率。

ObjectiveTo investigate the correlation analysis between nuclear transcription factor-κB, positive hepatic fatty acid binding protein and neonatal asphyxia renal injury. MethodsFrom July 2014 to July 2017,a total of 178 neonates with asphyxia were selected as observation group and divided into AKI group (n=58) and non AKI group (n=120) according to renal function injury. A total of 50 healthy full-term newborns born in obstetrics department of our hospital were selected as control group. NF-κB, L-FABP, BUN, Scr and 1min Apgar were compared among AKI group, non AKI group and control group, the correlation analysis and diagnostics study were carried out between the groups. ResultsNF-κB, L-FABP, BUN, Scr in AKI group were significantly higher than that in non-AKI group and control group, 1min Apgar was significantly lower than that in non-AKI group and control group,with statistical significance (P＜0.05). NF-κB, L-FABP in non AKI group were significantly higher than that in control group, 1min Apgar was significantly lower than that in control group,with statistical significance(P＜0.05). NF-κB, L-FABP, BUN, Scr of severe asphyxia children were significantly higher than that of mild asphyxia children, 1min Apgar was significantly lower than that of mild asphyxia children,with statistical significance(P＜0.05). There was a positive correlation between NF-κB, L-FABP and BUN, SCR in asphyxiated neonates, and a negative correlation between NF-κB, L-FABP and 1min Apgar score (P＜0.05). The sensitivity, specificity and accuracy of NF-κB combined L-FABP in the detection and diagnosis of neonates with asphyxiated kidney injury were 84.4%,90.0% and 88.2% (P＜0.05). ConclusionThe levels of NF-κB, L-FABP in asphyxia children were positively correlated with BUN or Scr level and negatively correlated with 1min Apgar.Joint detection of NF-κB and L-FABP is beneficial to assess the severity of neonatal asphyxia and early detection of neonatal asphyxia renal injury.