【摘要】 目的探讨新生儿缺氧缺血性脑病(HIE)患儿心肌损伤与脑损伤的关系。方法用微粒子化学发光免疫分析法检测187例HIE患儿(轻度82例、中度64例、重度41例)和150例健康对照者3种心肌损伤标志物[心肌肌钙蛋白I(cTnI)、肌酸激酶MB同工酶质量(CK-MB mass)和肌红蛋白(Mb)]浓度。结果重度和中度HIE患儿3种心肌损伤标志物均明显高于轻度HIE患儿及对照组(P<0.01);轻度HIE患儿出生第3天的cTnI异常率仅为6.1%,而中度达42.2%,重度则高达76.9%,3组比较差异有统计学意义(P<0.01)。轻度HIE患儿Mb浓度明显比对照组高(P<0.01),而cTnI和CK-MB mass 2组比较差异无统计学意义(P>0.05)。轻、中、重HIE患儿出生第1天Mb异常率最高,cTnI与CK-MB mass稍低;出生3 d后,Mb均持续下降,而cTnI和CK-MB mass却升至峰值,并维持在较高水平长达1周以上。结论HIE患儿心肌损伤与脑损伤紧密相联,即脑损伤越重,心肌损伤也越重。更多还原

【Abstract】 Objective To study the relationship between cardiac dysfunction and cerebral injury in neonates with hypoxic ischemic encephalopathy(HIE).Methods The serum levels of cardiac troponin I(cTnI),creatine kinase isoenzyme MB mass(CK-MB mass) and myoglobin(Mb) in neonates with HIE(82 mild,64 moderate and 41 severe) and 150 healthy controls were measured by microparticle chemiluminescent immunoassay.Results The levels of cTnI,CK-MB mass and Mb in neanates with severe and moderate HIE were higher than those in mild HIE and healthy controls(P<0.01).In the third day of birth,the abnormal ratio of cTnI in sereve HIE was 76.9%, in moderate HIE was 42.2% and in mild HIE was 6.1%.There were significantly difference in three groups(P<0.01).The levels of Mb in mild HIE group were sigificantly higher than that in controls(P<0.01).The levels of cTnI and CK-MB mass were not significantly different in mild HIE neonates and controls(P>0.05).In the first day of birth,abnormal ratio of Mb was the highest in mild,moderate and severe HIE,cTnI and CK-MB mass took second place.After the third day,the levels of Mb in three groups kept reduced but the cTnI and CK-MB mass increased to the peak and maintained more than one week at higher levels.Conclusions There is a close association between the cardiac dysfunction and cerebral injury in neonates with HIE.The more cerebral injury the patients have,the more severe cardiac dysfunction they would suffer.更多还原