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目的探讨血清肌钙蛋白I(cTnI)和磷酸肌酸激酶同工酶(CK-MB)对窒息新生儿心肌损伤的早期诊断价值。方法选择轻度窒息新生儿29例(轻度组)、重度窒息新生儿18例(重度组)。采用ELISA法和酶动力法检测新生儿血清cTnI水平和CK-MB活性。结果出生d1窒息新生儿血清cTnI和CK-MB水平在轻度组[(2.25±0.54)μg/L、(223.4±23.5)U/L]和重度组[(4.25±0.83)μg/L、(256.3±21.8)U/L]均显著高于对照组(Pa<0.01);重度组血清cTnI和CK-MB水平均显著高于轻度组(Pa<0.01)。治疗后d7窒息新生儿血清cTnI和CK-MB水平均明显下降,轻度组[(0.69±0.18)μg/L、(151.4±18.4)U/L]与对照组均无显著差异(Pa>0.05),重度组[(1.54±0.72)μg/L、(188.9±21.5)U/L]显著高于轻度组和对照组(Pa<0.01)。结论窒息新生儿伴心肌损伤时血清cTnI和CK-MB水平升高;动态观察可用于窒息新生儿微小心肌损伤的早期诊断。
Objective To investigate the value of serum cTnI and CK-MB in the early diagnosis of myocardial injury in neonates with asphyxia. Methods Twenty-nine neonates with mild asphyxia (mild group) and 18 neonates with severe asphyxia (severe group) were selected. Serum cTnI levels and CK-MB activity were measured by ELISA and enzyme kinetic assay. Results The levels of cTnI and CK-MB in neonates with d1 asphyxia at birth were significantly lower than those in mild group [(2.25 ± 0.54) μg / L, (223.4 ± 23.5) U / L] and severe group (4.25 ± 0.83) μg / 256.3 ± 21.8) U / L] were significantly higher than those in control group (Pa <0.01). Serum cTnI and CK-MB levels in severe group were significantly higher than those in mild group (Pa0.01). Serum levels of cTnI and CK-MB in neonates with d7 asphyxia after treatment were significantly lower than those in the control group (P 0. 05 ± 0. 18, / 151.4 ± 18.4 U / L, respectively) ) (1.54 ± 0.72 μg / L, (188.9 ± 21.5) U / L] in severe group were significantly higher than those in mild group and control group (Pa0.01). Conclusions Serum levels of cTnI and CK-MB are elevated in asphyxiated neonates with myocardial injury. The dynamic observation can be used for the early diagnosis of myocardial microvascular injury in asphyxiated neonates.