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缺氧缺血性脑病血和脑脊液LDH、CK及同工酶分析和相关性研究

Study on LDH,CK and Their Isoenzymes in Serum and CSF in Neonates with HIE and Their Correlation

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【作者】 姚裕家李顺品李炜如陈娟唐瑟杨凡王嵋景

【Author】 Yao Yujia,Li Shunpin,Li Weiru,et al.Department of Pediatrics,West China University of Medical Sciences,Chengdu,610041

【机构】 华西医科大学附属第二医院儿科攀枝花市妇幼保健院

【摘要】 目的 探讨不同程度缺氧缺血性脑病(HIE) 新生儿血清乳酸脱氢酶(LDH) 、肌酸激酶(CK)和同工酶活性变化及与脑脊液酶活性的相关性。 方法 47 例轻、中、重度HIE 和39 例正常儿均于生后48 小时内进行血清LDH 及同工酶LDH1,2,3,4,5 、CK 及同工酶CKMM,CKMB和CKBB活性检测。其中24 例患儿同时作血清和脑脊液酶活性的相关性分析。 结果 HIE中度和重度组血清LDH、CK、LDH3 ,4,5 和CKBB活性明显高于正常组和轻度组(P< 0.05),以LDH3 升高为著( P<0.01)。血清和脑脊液LDH3 ,4,5 、CK 和CKBB活性呈良好正相关( P< 0.05),其中CKBB 呈高度正相关( P< 0 .01) 。 结论 血清LDH、CK 和同工酶,尤其CKBB、LDH3 活性测定可代替脑脊液酶活性的检查,可作为缺氧缺血性脑损伤及程度评价的参考指标。

【Abstract】 Objective To explore the changes of lactic dehydrogenase (LDH),creatine kinase(CK) and isoenzymes activities in neonates with hypoxic ischemic encephalopathy(HIE) and to observe the correlations between enzyme values in serum and CSF as to provide lab evidence for diagnostic assessment of HIE. Methods 47 patients with HIE(including mild 15,moderate 15,severe 16)and 39 normal neonates(control group) were involved in the experiments.Serum enzymes were studied from all neonates in both case and control groups,and serum and CSF enzymes analyzed in 24 neonates with HIE. Results The activities of serum LDH,CK and isoenzymes increased gradually with the severity of the disease.The activities of serum LDH,CK and LDH 3,4,5 ,CK BB in moderate and severe HIE were significantly higher than those in mild and control group( P <0.05),particularly LDH 3( P <0.01).LDH 1,2 ,CK MM and CK MB only in severe HIE were evidently higher than mild and control group ( P <0.01).CK and LDH 3,4,5 and CK BB activities in serum were positively correlated with those in CSF in 24 patients with HIE,particularly CK BB activity( P <0.01). Conclusion The study suggested that it is likely that serum LDH,CK and isoenzymes concentrations are related to the severity of brain injury and the measurement of serum LDH,CK and isoenzymes,especially LDH 3,CK BB in patients with HIE may be useful for assessing brain damage and could be substituted for those in cerebrospinal fluid.

  • 【文献出处】 中华围产医学杂志 ,CHINESE JOURNAL OF PERINATAL MEDICINE , 编辑部邮箱 ,1999年01期
  • 【被引频次】40
  • 【下载频次】88
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