联合检测cTnI、MYO和CK-MB mass对HIE患儿心肌损伤的诊断研究  

Diagnostic Study on Myocardial Injury in Neonates with Hypoxic Ischemic Encephalopathy by Combined Determination of Cardiac Troponin I,Myoglobin and Creatine Kinase Isoenzyme MB Mass.

作　　者：马艳[1] 

机构地区：[1]四川省医学科学院附属医院儿科,简阳641400

出　　处：《医学研究杂志》2008年第9期69-72,共4页Journal of Medical Research

摘　　要：目的探讨联合检测心肌肌钙蛋白I(cTnI)、肌红蛋白(MYO)和肌酸激酶同工酶MB质量(CK-MB mass)对新生儿缺氧缺血性脑病(HIE)患者心肌损伤的诊断价值。方法用微粒子化学发光免疫分析法检测148名HIE患儿(轻度61名、中度52名、重度35名)及60名健康对照者cTnI、MYO和CK-MB mass。结果cTnI、MYO和CK-MB mass以HIE重度组最高,分别达(0.75±0.48)μg/L、(305.4±162.1)μg/L和(33.3±17.1)μg/L,中度组其次,分别为(0.33±0.23)μg/L、(178.6±89.3)μg/L和(15.2±8.8)μg/L,均明显高于轻度HIE组和对照组(F=62.96～127.35,P<0.01);轻度HIE患儿MYO明显高于对照组(P<0.01),而cTnI和CK-MB mass两组比较差异均无统计学意义(P>0.05)。轻度、中度和重度HIE患儿出生第1天,3种心肌损伤标志物均以MYO异常率最高。第3天轻度组cTnI、MYO和CK-MB mass异常率分别为6.56%、9.84%、8.20%,中度组分别为42.31%、44.23%、42.31%,重度组分别为77.14%、74.29%、77.14%。3天后,各组HIE患儿MYO均持续下降,而CK-MB mass和cTnI却升至峰值,并维持在较高水平长达1周以上。结论HIE患儿脑损伤与心肌损伤紧密相联——脑损伤越重,心肌损伤也越重。Objective To study the diagnostic value of myocardial damage by combined determination of cardiac troponin I （cTnI） , myoglobin （MYO） and ereatine kinase isoenzyme MB mass （CK -MB mass） in neonates with hypoxic ischemic encephalopathy （HIE）. Methods The concentrations of serum cTnI, MYO and CK - MB mass were measured in 148 patients with HIE （61 mild, 52 moderate and 35 severe） and in 60 healthy subjects by microparticlc chemiluminescent immunoassay. Results The study revealed that patients with severe and moderate HIE had sighifieant high levels of cTnI, MYO and CK - MB mass as compared with those with mild HIE and controls （analysis of variance [ ANOVA ] , P 〈 0.01 ） , the patients in severe HIE group had highest level of cTnI, MYO and CK - MB mass （0.75 ±0.48 μg/L, 305.4 ± 162.1μg/L and 33.3 ± 17.1 μg/L, respectively） , and the patients in moderate HIE group had sec- ondary higher concentrations of cTnI, MYO and CK - MB mass （0.33 ±0.23 μg/L, 178.6 ± 89.3μg/L and 15.2 ±8.8μg/L, respec- tively）. The level of MYO of patients with mild HIE was strongly higher than that of controls （ P 〈 0.01 ）. However, there were no signifi- cant difference in the serum concentrations of cTnl and CK - MB mass between the mild HIE group and controls （P 〉 0.05）. Not only in mild HIE but also in moderate HIE as well as in severe HIE in the first day of life, the abnormal ratio of MYO were the highest. In the third day of life, the seroprevalence of cTnI, MYO and CK - MB mass in mild HIE group were 6.56% , 9.84% and 8.20% , respective- ly ; and those of moderate HIE group were 42.31% , 44.23 % and 42.31% , respectively ; and severe HIE group had the highest abnormal ratio of cTnI （77.14%） , MYO （74.29%） and CK - MB mass （77.14%）. After the third day, the concentration of MYO in three HIE groups kept reduced but the CK - MB mass and cTnI increased to the peak and maintained above one week at higher levels. Conclusion There is a close association between the cardia

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

分 类 号：R542.22[医药卫生—心血管疾病] R722.12[医药卫生—内科学]