Urinary β2-microglobulin Concentration and Neonatal Complications in Premature Infants

尿液中β2-microglobulin濃度與早產兒併發症

10.6558/MTJM.2006.11(4).2

邱曉郁(Hsiao-Yu Chiu)；蘇百弘(Bai-Horng Su)；林鴻志(Hung-Chih Lin)；林國瑞(Kuo-Juei Lin)

新生兒併發症 ； 胎兒發炎反應 ； 早產兒 ； 尿中β2-microglobulin ； fetal inflammatory response ； neonatal complications ； premature infant ； β2-microglobulin

Mid-Taiwan Journal of Medicine

11卷4期（2006 / 12 / 01）

214 - 221

英文

目的　探討尿中β2-microglobulm(β-MG)濃度升高與早產兒併發症之相關。 方法　共75位出生體重小於1500公克之早產兒，在出生後48小時及28天收集尿液，以免疫分析法定量尿中β2-MG濃度，同時以尿中creatinine校正β2-MG的分泌。 結果　整體死亡率為8%。統計分析顯示，尿中β2-MG濃度升高與腦室旁白質軟化、壞死性腸炎及慢性肺病變有正相關，但與呼吸窘迫症、有症狀之開放動脈導管、肺出血、腦室出血、敗血症或早產兒視網膜病變無相關。 結論　出生早期尿中β2-MG濃度升高，且在出生後28天仍高的早產兒易發生腦室旁白質軟化、壞死性腸炎及慢性肺病變。

Purpose. To assess the correlation between elevated urinary beta2-microglobulin (β2-MG) and the risk of neonatal complications. Methods. Seventy-five very low birth weight (＜1500 g) premature infants were enrolled. β2-MG was measured by Immunometric assay within 48 hours and at 28 days after birth. Simultaneous urinary creatinine (Cr) was measured and used for normalization of β2-MG excretion. Results. The mortality rate was 8% (6/75). Multivariate logistic regression analysis revealed a positive association between elevated urinary β2-MG and periventricular leukomalacia (PVL) (OR=1.25, 95% CI=1.02 to 1.63 at 48 h; OR=1.18, 95% CI=1.09 to 1.42 at 28 d), necrotizing enterocolitis (NEC) (OR=1.12, 95% CI=1.02 to 1.24 at 48 h; OR=1.32, 95% CI=1.06 to 1.84 at 28 d), and chronic lung disease (CLD) (OR=1.92, 95% CI=1.24 to 2.13 at 48 h; OR=1.61, 95% CI=1.39 to 1.94 at 28 d). No similar association was found in respiratory distress syndrome, symptomatic PDA, pulmonary hemorrhage, intraventricular hemorrhage, sepsis, or retinopathy of prematurity. Conclusions. Urinary β2-MG was significantly higher at 48 hours and remained high until 28 days of age in premature infants who developed PVL, NEC and CLD.