窒息新生儿血浆心肌营养素-1的变化及其与心肌损伤的相关性  

Alteration of Plasma Cardiotrophin-1 in Neonates with Asphyxia and Its Correlation with Cardiac Injury

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,石家庄050011

出　　处：《实用儿科临床杂志》2009年第20期1583-1585,共3页Journal of Applied Clinical Pediatrics

基　　金：河北省科技厅科技支撑计划项目资助(072761601)

摘　　要：目的观察窒息新生儿脐血和外周血血浆心肌营养素-1(CT-1)动态变化,探讨其与心肌损伤的相关性。方法本院产科分娩足月窒息新生儿30例(脐血窒息组),健康对照组20例,娩出后立即抽取脐静脉血;本院儿科收治足月窒息新生儿40例(外周血窒息组,其中轻度22例、重度18例),无窒息对照患儿20例(外周血对照组),于出生24h内抽取外周静脉血。采用双抗体夹心酶标免疫分析法检测其血浆CT-1水平及心肌肌钙蛋白I(cTnI)水平。重度窒息组及外周血对照组于出生24h内应用多普勒超声心动图测定其左室射血分数(EF)、左室短轴缩短率(FS)。结果脐血窒息组新生儿CT-1水平较健康对照组明显增高(P<0.01),cTnI水平虽有升高,但与外周血对照组比较无明显差异(P>0.05),CT-1水平与cTnI水平无明显相关性。外周血窒息组新生儿CT-1水平较外周血对照组明显增高,重度窒息组显著高于轻度窒息组和外周血对照组(Pa<0.01),轻度窒息组与外周血对照组比较亦有显著性差异(P<0.01);重度窒息组cTnI水平显著高于轻度窒息组、外周血对照组(Pa<0.01),而轻度窒息组与外周血对照组比较无统计学差异(P>0.05);重度窒息组CT-1水平与cTnI水平呈显著正相关(P<0.05),轻度窒息组CT-1水平与cTnI水平无明显相关性。外周血对照组新生儿生后血浆CT-1水平较健康对照组略有升高,二者比较差异无统计学意义(P>0.05),窒息新生儿外周血CT-1水平较脐血明显增高(P<0.01)。重度窒息组EF、FS明显低于外周血对照组,且CT-1水平与EF、FS均呈显著负相关(Pa<0.05)。结论CT-1可反映窒息后缺氧性损害的程度。窒息后外周血CT-1水平较脐血升高更为明显。CT-1可能是早期诊断心肌损伤的灵敏指标,并能反映窒息后心功能变化。Objective To observe the dynamic alteration of plasma cardiotrephin - 1 （ CT - 1 ） in umbilical and peripheral blood of neonates with asphyxia,explore possible correlation between its changes and cardiac injury. Methods Thirty cases of full - term asphyxia newborn ,20 cases of healthy neonates were recruited ,4 mL blood was extracted from umbilical vein after delivery ;40 cases of fujl - term asphyxia newborn （including 22 mild cases and 18 severe cases） ,and 20 cases of control neonates without asphyxia were recruited ,4 mL blood was extracted from peripheral vein. The level of plasma cardiotrophin - 1 was detected by double - antibody sandwich enzyme immunoassay method and the level of Cardiac troponin I（cTnI） was detected within 24 h 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 control group. Results The level of plasma CT - 1 in umbilical blood of asphyxia infants was significantly higher than that of healthy control group （ P 〈0.01 ）, while the cTnl level was only slightly elevated without statistical significance（P 〉0.05 ） ,there was no directly correlation between the level of CT - 1 and cTnI. The level of plasma CT - 1 in peripheral blood of 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 mild one or in the control one （Pa 〈 0. 01 ）, and there was significant difference between the mild group and the normal group（P 〈0.01 ）. cTnI levels in the severe group were significantly higher than those in the mild group and the control group（Pa 〈 0.01 ） ,while there was no significant difference between the mild group and the normal group（ 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

关 键 词：窒息 心肌营养素-1 心肌损伤 婴儿 新生 

分 类 号：R722.1[医药卫生—儿科]