心肌损伤标志物检测对新生儿缺氧缺血性脑病患者心肌损伤的应用价值  

The value of the detection of myocardial injury markers for the diagnosis of cardiac dysfunction in neonates!with hypoxic ischemic encephalopathy

作　　者：刘成桂[1] 谢国明[1] 涂植光[1] 马艳[2] 邓成莲[2] 

机构地区：[1]重庆医科大学检验系,重庆400016 [2]四川省医学科学院附属医院儿科,四川简阳641400

出　　处：《检验医学》2008年第4期360-363,共4页Laboratory Medicine

基　　金：重庆市自然科学基金资助项目(CSTC;2006BB5272)

摘　　要：目的探讨新生儿缺氧缺血性脑病(HIE)患儿心肌损伤与脑损伤的关系。方法用微粒子化学发光免疫分析法检测187例HIE患儿(轻度82例、中度64例、重度41例)和150例健康对照者3种心肌损伤标志物[心肌肌钙蛋白I(cTnI)、肌酸激酶MB同工酶质量(CK-MB mass)和肌红蛋白(Mb)]浓度。结果重度和中度HIE患儿3种心肌损伤标志物均明显高于轻度HIE患儿及对照组(P<0.01);轻度HIE患儿出生第3天的cTnI异常率仅为6.1%,而中度达42.2%,重度则高达76.9%,3组比较差异有统计学意义(P<0.01)。轻度HIE患儿Mb浓度明显比对照组高(P<0.01),而cTnI和CK-MB mass 2组比较差异无统计学意义(P>0.05)。轻、中、重HIE患儿出生第1天Mb异常率最高,cTnI与CK-MB mass稍低;出生3 d后,Mb均持续下降,而cTnI和CK-MB mass却升至峰值,并维持在较高水平长达1周以上。结论HIE患儿心肌损伤与脑损伤紧密相联,即脑损伤越重,心肌损伤也越重。Objective To study the relationship between cardiac dysfunction and cerebral injury in neonates with hypoxic ischemic encephalopathy （HIE）. Methods The serum levels of cardiac troponin I （cTnI）, creatine kinase isoenzyme MB mass （CK-MB mass） and myoglobin （Mb） in neonates with HIE （82 mild, 64 moderate and 41 severe） and 150 healthy controls were measured by microparticle chemiluminescent immunoassay. Results The levels of cTnI, CK-MB mass and Mb in neanates with severe and moderate HIE were higher than those in mild HIE and healthy controls （P 〈 0.01）. In the third day of birth, the abnormal ratio of cTnI in sereve HIE was 76.9% , in moderate HIE was 42.2% and in mild HIE was 6.1%. There were significantly difference in three groups （P 〈 0.01 ）. The levels of Mb in mild HIE group were sigificantly higher than that in controls （P 〈0.01 ）. The levels of cTnl and CK-MB mass were not significantly different in mild HIE neonates and controls （ P 〉 0.05 ）. In the first day of birth, abnormal ratio of Mb was the highest in mild, moderate and severe HIE, cTnI and CK-MB mass took second place. After the third day, the levels of Mb in three groups kept reduced but the cTnI and CK-MB mass increased to the peak and maintained more than one week at higher levels. Conclusions There is a close association between the cardiac dysfunction and cerebral injury in neonates with HIE. The more cerebral injury the patients have, the more severe cardiac dysfunction they would suffer.

关 键 词：心肌肌钙蛋白I 肌酸激酶MB同工酶质量 肌红蛋白 新生儿 缺氧缺血性脑病 

分 类 号：R446.1[医药卫生—诊断学]