胎儿宫内窘迫对新生儿血清心肌酶变化的相关性分析  

Correlation Analysis on Effect of Fetal Distress on Changes of Cardiac Enzyme in Neonatal Serum

作　　者：朱波[1] 

机构地区：[1]崇州市妇幼保健院,四川崇州611230

出　　处：《华西医学》2011年第11期1656-1658,共3页West China Medical Journal

摘　　要：目的探讨胎儿宫内窘迫对足月新生儿血清心肌酶变化的相关性分析。方法将2009年10月2010年9月在我产科出生有宫内窘迫史而羊水和Apgar评分均正常的足月新生儿20例为观察组,同期出生的健康足月新生儿10例为对照组,分别测定两组出生后1、5d血清肌酸激酶同工酶(CK-MB)及心肌肌钙蛋白I(cTnI)水平。结果观察组出生后1d血清cTnI高于对照组(P<0.001),CK-MB两组差异无统计学意义(P>0.05),出生后5d血清CK-MB及cTnI均高于对照组(P<0.001);观察组和对照组出生后5d血清cTnI水平均较1d时升高,差异有统计学意义(P<0.001),血清CK-MB浓度均低于1d时(P<0.001)。观察组患儿经过治疗,1个月后复查血清cTnI除1例未恢复至正常水平外,其余血清CK-MB及心电图均恢复正常。结论单纯宫内窘迫可造成足月新生儿血清cTnI及CK-MB水平升高,常规检测血清cTnI及CK-MB能及时了解此类新生儿的心肌受损情况,从而尽早予以保护心肌治疗。Objective To make a correlation analysis on effect of fetal distress on changes of cardiac enzyme in neonatal serum.Methods Twenty full-term newborns who met diagnostic criteria of fetal distress but were born with normal amniotic fluid and Apgar score between October 2009 and September 2010 were included in the observed group,another ten normal full-term newborns born at same period were in control group.The serum values of cardiac troponin I（cTnI） and creatine kinase（CK-MB） were collected and measured one and five days after birth.Results One day after the birth,the serum levels of cTnI was significantly higher in the observed group compared to that in the control group（P0.001）,but there was no difference in CK-MB between the two groups（P0.05）.The values of cTnI five days after the birth were higher than those one days after the birth in both groups（P0.001）.The values of CK-MB were higher one day after birth than those five days after birth in both groups（P0.001）.In observation group after the treatment,serum cTnI in one patient did not return to normal,and the remaining neonatal serum CK-MB and ECG were normal.Conclusions Elevated level of serum cTnI and CK-mb could be caused by fetal distress in normal full-term newborns with normal amniotic fluid and Apgar score.Routine testing of serum cTnI and CK-MB may be useful to detect myocardial damage in newborns.

关 键 词：宫内窘迫 心肌肌钙蛋白I 磷酸肌酸激酶心型同工酶 新生儿 

分 类 号：R714.5[医药卫生—妇产科学]