新生儿高胆红素血症与心肌损伤的相关性  

Relationship between unconjugated hyperbilirubinemia and myocardial damage of neonates

作　　者：刘新晖[1] 黄玫[1] 孙正香[1] 黄瑞文[1] 吴运芹[1] 

机构地区：[1]湖南省儿童医院新生儿科,湖南长沙410007

出　　处：《中国妇幼健康研究》2007年第6期470-472,共3页Chinese Journal of Woman and Child Health Research

摘　　要：目的研究高胆红素血症对心肌是否可造成损伤。方法选50例高未结合胆红素血症患者分别在胆红素升高与恢复期测定心肌酶谱、肌钙蛋白Ⅰ、心电图QT离散度的不同值,进行统计分析。结果心肌酶谱、肌钙蛋白Ⅰ、心电图QT离散度在胆红素升高时均有明显升高,在恢复期下降至正常。特别是肌钙蛋白Ⅰ和心电图QT离散度表现更为明显。在高胆红素血症时,肌酸激酶(453.00±81.20IU/L)、肌酸激酶同工酶(46.40±4.50IU/L)、肌钙蛋白Ⅰ(0.24±0.06ng/mL)和心电图QT离散度(57.33±30.60M s)的阳性率分别为86%、80%、84%和52%;治疗前、后经t检验,t值分别为5.585、5.860、4.317和4.424,均P<0.05,有明显的统计学意义。结论高胆红素血症可引起心肌的损伤,但具有可恢复性;肌钙蛋白Ⅰ、QTd是心肌损伤的重要指标,较心肌酶谱更有意义。Objective To investigate relationship between unconjugated hyperbilirubinemia and myocardial damage of neonates.Methods 50 neonates with uncongated hyperbilirubinemia were prospectively studied.The levels of myocardial enzymes and cardiac troponin-Ⅰ(CTN-Ⅰ) were detected in bilirubin elevating period and recovery period respectively,at the same time,the QT interval dispersion degree(QTd) on ECG were examined.Results Myocardial enzymes,CTN-Ⅰ and QTd on ECG were increased significantly in bilirubin elevating preiod and fell to normal ranges in recovery period,especially CTN-Ⅰand QTd.In unconjugated hyperbilirubinemia period,the positive rates of creatine kinase(CK)(453.00±81.20 IU/L),CK-MB(46.40±4.50 IU/L),CTN-Ⅰ(0.24±0.06 ng/mL) and QTd(57.33±30.60 Ms) were 86%,80%,84% and 52%,respectively.After treatment,the values of all indexes decreased at varied extent and there were significant differences as compared with those before treatment(t=5.585,5.860,4.317 and 4.424,respectively,all P<0.05).Conclusion Hyperbilirubinemia can cause myocardial damage,but it not seems to cause permanent damage to nervous system and the damage caused is reversible.CTN-Ⅰ and QTd are very important indexes of myocardial damage and they are more significat than myocardial enzymes.

关 键 词：新生儿 高胆红素 心肌损伤 相关性 

分 类 号：R722.17[医药卫生—儿科]