【摘要】 目的观察窒息新生儿血清磷酸肌酸激酶同工酶(CK-MB)与肌钙蛋白Ⅰ(cTnⅠ)值的变化,探讨窒息新生儿缺氧程度与心肌损害程度的关系。方法将2010年1月至2013年6月60例窒息新生儿(观察组)确诊当天和30例无窒息的新生儿(对照组)出生后3 d的CK-MB与cTnⅠ值进行对比分析。结果观察组重度患儿与轻度患儿的平均血清CK-MB分别为(108.5±17.2)U/L、(70.4±15.3)U/L,均明显高于对照组的(25.7±1.2)U/L,差异均具有统计学意义(P<0.05)。观察组重度患儿与轻度患儿的平均血清肌钙蛋白Ⅰ值分别为(0.38±0.03)μg/ml、(0.22±0.02)μg/ml,明显高于对照组的(0.13±0.01)μg/ml,差异均具有统计学意义(P<0.05)。观察组重度窒息患儿平均血清CK-MB与肌钙蛋白Ⅰ值明显高于轻度窒息患儿(P<0.05);窒息新生儿日龄越小,其血清CK-MB与肌钙蛋白I值越高,随着治疗而逐渐下降。结论窒息新生儿的缺氧程度与心肌损害程度之间呈正相关性,血清CK-MB与肌钙蛋白Ⅰ值的变化可作为窒息新生儿心肌损害早期诊断敏感而特异的指标,具有判断病情轻重、指导临床治疗及判断疾病转归的重要意义。更多还原

【Abstract】 Objective To investigate the changes of serum creatine kinase MB(CK-MB) and cardiac troponin Ⅰ(cTnⅠ) in neonates with asphyxia, and to explore the relationship between the degree of hypoxia and myocardial damage. Methods From January 2010 to June 2013, 60 neonates of asphyxia(the observation group) on the day of diagnosis and 30 neonates without asphyxia(the control group) 3 days after birth were analyzed and compared for CK-MB and troponinⅠ value. Results The mean serum CK-MB for neonates with severe asphyxia, mild asphyxia in the observation group were(108.5±17.2) U/L,(70.4±15.3) U/L, which were significantly higher than(25.7±1.2) U/L in the control group(t=4.58, 11.53, P<0.05). The mean value of serum cardiac troponinⅠ for neonates with severe asphyxia, mild asphyxia in the observation group were(0.38±0.03) μg/ml,(0.22±0.02) μg/ml, which were significantly higher than(0.13±0.01) μg/ml in control group(t=1.28, 2.71, P<0.05). In the observation group, the mean serum CK-MB and troponinⅠ of neonates with severe asphyxia were significantly higher than those in neonates with mild asphyxia(t=1.28, 2.71, P<0.05). The younger the neonates, the higher the serum CK-MB and troponinⅠ value, which were decreased with treatment. Conclusion There was a positive correlation between the degree of hypoxia and myocardial damage in neonatal asphyxia. The changes of serum CK-MB and troponinⅠ value can be used as sensitive and specific indicators for the early diagnosis of myocardial damage in neonatal asphyxia, which has an important significance to judge the severity, guide clinical treatment and evaluate the prognosis of the disease.更多还原