胎儿血清β_2-微球蛋白及α_1-微球蛋白评估泌尿系畸形胎儿肾功能

发布时间：2018-10-29 16:52

【摘要】：目的探讨胎儿血清β2-微球蛋白(β2-microglobulin,β2-MG)及α1-微球蛋白(α1-micro-globulin,α1-MG)对评估胎儿肾功能的价值。方法通过脐带穿刺取得胎儿血,对134例产前诊断结果正常的胎儿(对照组)以及50例泌尿系畸形的胎儿,采用放射免疫分析法检测血清β2-MG及α1-MG含量。将对照组测得的结果建立参考值,通过与参考值比较,评价泌尿系畸形胎儿的肾功能。同时配对检测30例孕母和胎儿血清β2-MG、α1-MG、尿素氮(blood urea nitrogen,BUN)、肌酐(creati-nine,Cr)含量。结果妊娠16~33周正常胎儿血清β2-MG、α1-MG含量分别为(4.77±0.86)mg/L、(47.86±9.88)mg/L,与孕周变化无相关;妊娠34周后含量下降,分别为(3.68±0.49)mg/L、(38.36±6.32)mg/L;严重泌尿系畸形或生后肾功能异常的胎儿β2-MG、α1-MG含量明显升高。作为评估胎儿肾功能的指标,α1-MG比β2-MG具有更高的敏感性和特异性。BUN和Cr在母、胎血清的含量呈正相关;而β2-MG、α1-MG的母、胎血清含量无相关。结论泌尿系畸形胎儿血清β2-MG、α1-MG含量的增高反映了肾小球滤过率的下降,它们均可作为产前检测胎儿肾功能和预测生后肾功能的指标。二者比较,α1-MG更为有效。血清BUN和Cr不能反映胎儿肾功能。
[Abstract]:Objective to investigate the value of fetal serum 尾 2-microglobulin (尾 2-MG) and 伪 1-micro-globulin (伪 1-MG) in evaluating fetal renal function. Methods Fetal blood was obtained by umbilical cord puncture. Serum 尾 2-MG and 伪 1-MG levels were measured by radioimmunoassay in 134 fetuses with normal prenatal diagnosis (control group) and 50 fetuses with urinary system malformations. The reference value of the control group was established and compared with the reference value to evaluate the renal function of the fetus with urinary system malformation. Serum 尾 _ 2-MG, 伪 _ 1-MG, urea nitrogen (blood urea nitrogen,BUN) and creatinine (creati-nine,Cr) were measured in 30 pregnant women and foetus at the same time. Results the levels of 尾 2-MG and 伪 1-MG in normal fetuses were (4.77 卤0.86) mg/L, (47.86 卤9.88) mg/L, and (47.86 卤9.88) mg/L, respectively. After 34 weeks of gestation, the content of 尾 2-MG and 伪 1-MG in fetus with (3.68 卤0.49) mg/L, (38.36 卤6.32) mg/L; or abnormal postnatal renal function were significantly increased. As an index to evaluate fetal renal function, 伪 1-MG has higher sensitivity and specificity than 尾 2-MG. BUN and Cr have positive correlation in maternal fetal serum, while 尾 2-MG, 伪 1-MG in maternal, fetal serum content has no correlation. Conclusion the increase of serum 尾 _ 2-MG, 伪 1-MG levels in the fetus with urinary malformation reflects the decrease of glomerular filtration rate, which can be used as an index for prenatal detection of fetal renal function and prediction of postnatal renal function. 伪 1-MG is more effective than 伪 1-MG. Serum BUN and Cr do not reflect fetal renal function.
【作者单位】：中山大学附属第一医院妇产科胎儿医学中心中山大学附属第一医院妇产科胎儿医学中心中山大学附属第一医院妇产科胎儿医学中心中山医科大学附属第一医院肾科
【分类号】：R714.5

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