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目的探讨新生儿病理性黄疸对心脏功能的损害。方法将2013年6月-2015年6月肇庆市广宁人民医院80例新生儿黄疸患儿分为生理性黄疸组和病理性黄疸组,每组各40例。同时选取40例正常新生儿作为健康对照组。对比分析3组新生儿的血清总胆红素、血清肌酸激酶(CK)、肌酸激酶同工酶(CK-MB)、高敏心肌肌钙蛋白T(hs-c Tn I),同时对比研究三组新生儿的心电图差异,随访1年。结果与健康对照组新生儿相比,生理性黄疸组和病理性黄疸组患儿的血清总胆红素、c Tn I、CK-MB、CK水平均明显升高,差异有统计学意义(P<0.05),且病理性黄疸组患儿比生理性黄疸组升高也显著,差异有统计学意义(P<0.05);此外,三组患儿的超声心电图和心电图指标如射血分数、E/A值、二尖瓣和三尖瓣返流速等均符合国内健康新生儿标准。结论新生儿病理性黄疸对新生儿心脏功能的影响并不十分显著,在临床实际诊疗过程中需结合心肌酶谱值、心脏彩超以及心电图的改变等手段进行全面分析。
Objective To investigate the damage of neonatal pathological jaundice to cardiac function. Methods From June 2013 to June 2015, 80 neonates with jaundice from Guangning People’s Hospital of Zhaoqing City were divided into physiological jaundice group and pathological jaundice group, 40 cases in each group. Forty normal newborns were selected as healthy control group. The levels of serum total bilirubin, CK, CK-MB and hs-c Tn I in three groups of neonates were compared and analyzed. Three groups of neonatal ECG differences, followed up for 1 year. Results Compared with the healthy control group, the levels of serum total bilirubin, cTn I, CK-MB and CK in physiological jaundice group and pathological jaundice group were significantly increased (P <0.05), and the pathological jaundice group than the physiological jaundice group also increased significantly, the difference was statistically significant (P <0.05); In addition, three groups of children with echocardiography and ECG indicators such as ejection fraction, E / A value, mitral and tricuspid regurgitation rates are in line with the domestic standard of healthy newborn. Conclusion Neonatal pathological jaundice has no significant effect on neonatal cardiac function. In clinical practice, comprehensive analysis should be carried out with the combination of myocardial enzyme spectrum, echocardiography and ECG changes.