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目的 探讨窒息新生儿尿酶改变及其与外周血白细胞计数的关系。方法 28例窒息新生儿，分为轻度窒息组(10例)和重度窒息组(18例)；另外选择9例正常新生儿作对照组，检测各组外周血白细胞计数、尿N乙酰β氨基酸葡萄糖苷酶(NAG)和γ谷胺酰转肽酶(GGT)，比较各组间白细胞计数及其与NAG、GGT的关系。结果 外周血白细胞计数、NAG、GGT重度窒息组分别为(27.42±10.95)×109/L，(34.28±26.18) U/L，(30.50±21.10) U/L，轻度窒息组分别为(10.24±4.10)×109/L，(10.34±8.72) U/L，(16.80±6.48) U/L，对照组分别为(15.70±3.21)×109/L，(2.73±2.50) U/L，(8.75±2.43) U/L。重度窒息组与轻度窒息组和对照组比较，外周血白细胞计数、NAG、GGT均显著升高(P<0.05)。轻度窒息组与正常组比较，除外周血白细胞计数外，NAG和GGT也显著升高(P<0.05)。直线相关分析显示：重度窒息组外周血白细胞计数与尿NAG呈显著正相关关系(γ=0.41，P<0.05)，与GGT呈正相关关系，但无显著性(P>0.05)。结论 外周血白细胞计数升高与新生儿窒息程度和尿酶升高程度密切相关，在临床上可将外周血白细胞计数作为窒息后肾损伤的预警参数。
Objective To investigate the changes of urinary enzymes in neonates with asphyxia and their relationship with peripheral blood leukocyte counts. Methods Twenty-eight neonates with asphyxia were divided into mild asphyxia group (n = 10) and severe asphyxia group (n = 18). Nine normal newborns were selected as control group. Peripheral white blood cell count, urinary N-acetyl- NAG and GGT. The white blood cell count and its relationship with NAG and GGT were compared between groups. Results The numbers of peripheral blood leukocytes, (27.42 ± 10.95) × 109 / L, (34.28 ± 26.18) U / L and (30.50 ± 21.10) U / L respectively in NAG group and GGT severe asphyxia group were 10.24 (4.70 ± 3.21) × 109 / L, (2.73 ± 2.50) U / L, (10.34 ± 8.72) U / L and (16.80 ± 6.48) U / 8.75 ± 2.43) U / L. Compared with mild asphyxia group and control group, the white blood cell count, NAG and GGT in severe asphyxia group were significantly increased (P <0.05). Mild asphyxia group compared with the normal group, in addition to the peripheral blood leukocyte count, NAG and GGT were significantly increased (P <0.05). Linear correlation analysis showed that there was a positive correlation between peripheral white blood cell count and urinary NAG in severe asphyxia group (γ = 0.41, P <0.05), but no significant correlation with GGT (P> 0.05). Conclusion The increase of peripheral white blood cell count is closely related to the degree of neonatal asphyxia and the increase of urinary enzymes. The peripheral white blood cell count can be used as the early warning parameter of renal injury after asphyxia.