窒息新生儿血清肌钙蛋白I和磷酸肌酸激酶同工酶变化的意义  

Significance of Serum Cardiac Troponin I and Creatine Phosphokinase-Isoenzyme-MB in Asphyxia Neonate

作　　者：余新超[1] 王慧[2] 王立金[1] 

机构地区：[1]安徽理工大学医学院心血管病研究室,安徽淮南232001 [2]淮南新华医院儿科,安徽淮南232058

出　　处：《实用儿科临床杂志》2007年第2期117-118,共2页Journal of Applied Clinical Pediatrics

基　　金：安徽省教育厅自然科学基金项目资助(2003kj113)

摘　　要：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 explore the value of cardiac troponin I （cTnI） and creatine phosphokinase-isoenzyme - MB （ CK - MB ） on early diagnosis of heart damage in asphyxia neonate. Methods A total of 47 cases of asphyxia neonates were divided into mild - asphyxia group （n = 29 ） and severe -asphyxia group （n = 18 ）, and the levels of cTnI and CK - MB were quantitatively determinated by ELISA and enzyme kinetics, respectively. Results After birth for the first day, the serum levels of cTnI and enzymatic activities of CK - MB were all significantly higher in mild - asphyxia group [ （2.25 ± 0.54） μg/L, （ 223.4 ± 23.5 ） U/L ] and severe - asphyxia group [ （4.25 ± 0.83 ） μg/L, （ 256.3 ± 21.8 ） U/L） ] than those in control group（ Pα 〈 0.01 ） , and the results in severe -asphyxia group were significantly higher than those in mild - asphyxia group（ Pα 〈0.01 ）. On the 7th day after treatment, the serum levels of cTnI and enzymatic activities of CK - MB were no significant differences between the mild - asphyxia group [ （0.69 ± 0.18 ）μg/L, （ 151.4 ± 18.4 ） U/L ] and control group （ Pa 〉 0.05 ） , however the results in severe - asphyxia group [ （ 1.54 ± 0.72 ） μg/L, （ 188.9 ± 21.5 ） U/L] were significantly higher than those in control group （ Pα 〈 0.01 ）. Conclusion High levels of cTnI and CK - MB have been confirmed,and may be used for early diagnosis of myocardial injury in asphyxia neonate.

关 键 词：心肌肌钙蛋白I 心肌损伤 窒息 婴儿 新生 磷酸肌酸激酶同工酶 

分 类 号：R722.12[医药卫生—儿科]