新生儿窒息后血浆心肌营养素-1的变化及临床意义  

Alteration of cardiotrophin-1 after neonatal asphyxia and its clinical significance

作　　者：刁玉巧[1] 江莲[1] 李梅[1] 张会芬[1] 戎小平[1] 赵孝先[1] 朱秀丽[1] 

机构地区：[1]河北医科大学第四医院儿科,河北石家庄050011

出　　处：《中国儿童保健杂志》2009年第4期419-421,共3页Chinese Journal of Child Health Care

基　　金：河北省科技支撑计划项目(072761601)

摘　　要：【目的】探讨新生儿窒息后血浆心肌营养素-1(cardiotrophin-1,CT-1)水平变化及临床意义。【方法】足月新生儿窒息组40例(轻度组22例、重度组18例),正常对照组20例,于生后24 h内抽取外周静脉血,采用双抗体夹心酶标免疫分析法检测血浆CT-1水平,并检测肌钙蛋白I(cardiac troponin I,CTnI)水平。重度组及对照组于生后24 h内应用多普勒超声心动图测定其左室射血分数(left ventricle ejection fraction,EF)、左室短轴缩短率(left ventricle short-ening fraction,FS)。【结果】窒息组新生儿血浆CT-1水平较对照组明显增高,重度组显著高于轻度组、对照组(P均<0.01),轻度组与对照组比较差异亦有显著性(P<0.01);CTnI水平重度组显著高于轻度组、对照组(P均<0.01),而轻度组与对照组比较差异无显著性(P>0.05)。重度组CT-1水平与CTnI水平呈正相关,轻度组CT-1水平与CTnI水平无明显相关性。重度组EF、FS明显低于对照组,且CT-1水平与EF、FS呈负相关。【结论】新生儿窒息后血浆CT-1水平明显升高;CT-1可能是诊断心肌损伤的更灵敏指标。[Objective] To explore the alteration of cardiotrophin-1 （CT-1） after neonatal asphyxia and its clinical significance; [Methods] 40 cases of full-term asphyxia newborn （including 22 light cases and 18 severe cases）, and 20 cases of control were recruited in the study. The level of plasma CT-1 was detected by double-antibody sandwich enzyme immunoassay method and the level of cardiac troponin I（CTnI） was detected within 24h after delivery. Doppler echocardiography was applied to measure left ventricle ejection fraction（EF）and left ventricle shortening fraction（FS）in the severe group and the controls. [Results] The level of plasma CT-1 in asphyxia infants was significantly higher than that of control group, plasma CT-1 levels in the severe asphyxia were significantly higher than those in the light one or in the control one（P〈0.01 ）, and there were significant differences between the light group and the normal one（P〈0. 01 ）. CTnI levels in the severe group were significantly higher than those in the light one or in the control one（P〈0.01）, while there was no significant difference between the light group and the normal one（P〉0.05）. The level of CT-1 was directly correlated with the level of CTnI in the severe group（P〈0. 05）, while there was no directly correlation between the level of CT-1 and CTnI in the light one. EF and FS in the severe group were significantly lower than those in control group, which were negatively correlated with the level of CT-I（P〈0. 05）. [Conclusions] The plasma CT-1 level is significantly increased in asphyxia infants. CT-1 may be a more sensitive marker for the diagnosis of cardiac injury.

关 键 词：新生儿窒息 心肌营养素-1 心肌损伤 

分 类 号：R722.12[医药卫生—儿科]