缺氧缺血性心肌损伤新生儿血浆心肌营养素-1的变化及意义  

Changes of plasma cardiotrophin-1 levels in neonates with myocardial ischemic injury

作　　者：刁玉巧[1] 江莲[1] 张会芬[1] 曲凡[1] 沈颖[1] 邵勤[2] 

机构地区：[1]河北医科大学第四医院儿科,河北石家庄050011 [2]河北医科大学附属邢台市人民医院儿科,河北邢台054000

出　　处：《中国当代儿科杂志》2015年第2期118-121,共4页Chinese Journal of Contemporary Pediatrics

基　　金：河北省科技计划项目(12277770)

摘　　要：目的观察血浆心肌营养素-1(CT-1)在新生儿缺氧缺血性脑病(HIE)合并心肌损伤中的变化及临床意义。方法选择HIE患儿45例(轻度15例、中度24例、重度6例)为观察组,根据有无心肌损伤分为心肌损伤组(19例)和无心肌损伤(26例)两个亚组。20例正常新生儿为对照组。采用双抗体夹心酶标免疫分析法检测血浆CT-1水平。同时检测血清肌酸激酶同工酶(CK-MB)和心肌肌钙蛋白I(CTn I)水平。结果轻度、中/重度HIE组血浆CT-1水平分别为169±20、287±44 pg/m L,均高于对照组(30±8 pg/m L)(P<0.01),且中/重度HIE组高于轻度HIE组(P<0.01)。HIE患儿急性期血浆CT-1水平与血清CK-MB、CTn I均呈显著正相关(r分别为0.565、0.621,均P<0.01)。心肌损伤亚组血浆CT-1水平较非心肌损伤亚组升高(249±35 pg/m L vs 177±26 pg/m L;P<0.01)。心肌损伤亚组急性期血浆CT-1水平(249±35 pg/m L)明显高于恢复期(157±19 pg/m L)(P<0.01)。结论检测HIE患儿血浆CT-1水平有助于HIE新生儿心肌损伤的诊断,且有助于判断HIE病情。Objective To study the changes and significance of plasma cardiotrophin-1（CT-1） in neonates with hypoxic-ischemic encephalopathy（HIE） complicated by myocardial ischemic injury. Methods Forty-five neonates with HIE（15 mild cases, 24 moderate cases and 6 severe cases） were enrolled and divided into two subgroups based on the presence of myocardial injury（n=19） and not（n=26）. Twenty healthy neonates were used as the control group. Plasma CT-1 levels were measured using double-antibody sandwich enzyme immunoassay method. Serum creatinine kinase MB（CK-MB） and cardiac troponin I（CTn I） levels were also measured. Results Plasma CT-1 levels in the mild HIE（169±20 pg/m L） and moderate/severe HIE subgroups（287±44 pg/m L） were significantly higher than those in the control group（30±8 pg/m L）, and plasma CT-1 levels were associated with the severity of HIE（P〈0.01）. Plasma CT-1 levels were positively correlated with serum CK-MB and CTn I levels in neonates with HIE in the acute phase（r=0.565 and 0.621 respectively; P〈0.01）. Plasma CT-1 levels in neonates with myocardial injury were significantly higher than those without myocardial injury（249 ±35 pg/m L vs 177±26 pg/m L; P〈0.01）. Plasma CT-1 levels were significantly reduced in neonates with myocardial injury in the convalescent phase（157±19 pg/m L） compared with those in the acute phase（249±35 pg/m L; P〈0.01）. Conclusions Detection of plasma CT-1 levels may be useful in the diagnosis of myocardial ischemic injury and the severity evaluation of HIE.

关 键 词：心肌营养素-1 缺氧缺血性脑病 心肌损伤 新生儿 

分 类 号：R722.1[医药卫生—儿科]