心型脂肪酸结合蛋白在新生儿窒息合并心肌损害早期诊断中的应用  

Application of H-FABP in early diagnosis of myocardial injury in neonatal asphyxia

作　　者：魏继红[1] 柏金秀[1] 姬静璐[1] 杨小巍[1] 于荣林[2] 赵顺宇 赵秀文[3] 

机构地区：[1]河北大学附属医院儿科,河北保定071000 [2]河北省保定市阜平县医院儿科,河北保定073200 [3]河北省保定市第七医院儿科,河北保定072150

出　　处：《现代预防医学》2015年第16期2943-2945,2978,共4页Modern Preventive Medicine

摘　　要：目的了解血清心型脂肪酸结合蛋白(H-FABP)对新生儿窒息合并心肌损害的早期诊断价值。方法选择全院儿科新生儿病房2013年1月-2013年12月收治的62例窒息新生儿为实验组(轻度窒息52例,重度窒息10例),于窒息后3 h、6 h检测血清H-FABP浓度,同时检测肌钙蛋白I(c Tn I)浓度,并选择36例健康新生儿为对照组。实验组最终确定心肌损害27例,无心肌损害35例,比较两组间H-FABP和c Tn I水平,并比较H-FABP、c Tn I检测心肌损害的灵敏度和特异度。结果重度窒息组于发病后3 h、6 h H-FABP水平高于对照组,差异有统计学意义(t=19.60,P<0.01;t=35.24,P<0.01),轻度窒息组各时间段H-FABP水平稍高于对照组,但无统计学差异(t=2.15,P>0.05;t=1.37,P>0.05),重度窒息组于发病后3 h、6 h H-FABP水平高于轻度窒息组,差异有统计学意义(t=18.31,P<0.01;t=30.58,P<0.01)。心肌损害组在窒息后3 h H-FABP水平、窒息后6 h H-FABP和c Tn I水平高于无心肌损害组,差异有统计学意义(t=26.43,P<0.01;t=64.21,P<0.01;t=89.12,P<0.01)。窒息后3 h、6 h H-FABP检测心肌损害的灵敏度均高于c Tn I(χ2=5.74,P<0.01;χ2=3.92,P<0.01),特异度二者无显著性差异。结论H-FABP在窒息患儿发生心肌损害后升高时间早于c Tn I,且敏感度和特异度均较好,可作为早期诊断窒息后心肌损害的理想标志物。Objective The aim of this study was to investigate the application of H-FABP in early diagnosis of myocardial injury in neonatal asphyxia. Methods Sixty-two newborns with asphyxia（52 with mild asphyxia and 10 with severe asphyxia） from our NICU were chosen as the case group in this research. The levels of blood H-FABP and c Tn I were examined at 3h and 6h after asphyxia.The results were compared with 36 healthy newborns. The case group was divided into myocardial injury group（MIG） and non-myocardial injury group（NMIG）. Then the levels of H-FABP and c Tn I were compared between the two groups. The sensitivity and specificity of H-FABP and c Tn I in the diagnosis of myocardial injury were also compared in this study. Results The level of plasma H-FABP at 3h and 6h after severe asphyxia were higher than those of the control group（t=19.60, P〈0.01; t=35.24, P〈0.01）.The level of H-FABP at 3h and 6h after mild asphyxia was slightly higher than that of the control group, but there was no statistical difference found（t=2.15, P〈0.05; t=1.37, P〈0.05）. The level of plasma H-FABP at 3h and 6h after severe asphyxia were higher than those of mild asphyxia group（t=18.31, P〈0.01; t=30.58, P〈0.01）. The statistical differences of H-FABP level were found between the MIG and NMIG at 3h and 6h after asphyxia（t=26.43, P〈0.01; t=64.21, P〈0.01）, while the c Tn I value between the MIG and NMIG was only different at 3h after asphyxia（t=89.12, P〈0.01）. The sensitivity of H-FABP were higher than those of c Tn I at 3h and 6h（χ^2=5.74, P〈0.01; χ^2=3.92, P〈0.01）. The specificity of H-FABP was equal to that of c Tn I. Conclusion H-FABP was better than c Tn I in early diagnosis of myocardial injury in asphyxia.

关 键 词：窒息 心肌损害 婴儿 新生 心型脂肪酸结合蛋白 

分 类 号：R17[医药卫生—妇幼卫生保健]