超敏C反应蛋白联合心肌酶谱测定在早产窒息新生儿中的临床价值  

Clinical value of high-sensitivity C-reactive protein combined with myocardial enzyme detection in premature infant with asphyxia

作　　者：谭代林[1] 徐莉芳[1] 

机构地区：[1]湖北省潜江市中心医院检验科,433100

出　　处：《中国实用医药》2016年第31期13-15,共3页China Practical Medicine

摘　　要：目的探讨超敏C反应蛋白(hs-CRP)联合心肌酶谱检测在早产窒息新生儿中的临床价值,为临床鉴别诊断及治疗早产患儿提供科学依据。方法 80例早产窒息高胆红素血症患儿,按疾病严重程度分为轻度窒息组(48例)和重度窒息组(32例);同时选择正常新生儿生理性黄疸患儿50例为对照组,分别进行血清总胆红素(TBIL)、hs-CRP、心肌酶谱测定,将三组上述指标进行临床对比分析。结果轻度窒息组、重度窒息组的谷草转氨酶(AST)、乳酸脱氢酶(LDH)、肌酸激酶(CK)、肌酸激酶同工酶(CK-MB)、α-羟丁酸脱氢酶(α-HBD)及hs-CRP与对照组比较均明显升高(P<0.05)。轻度窒息组、重度窒息组的TBIL水平均高于对照组(P<0.05)。TBIL水平与hs-CRP浓度呈正相关。结合临床资料及彩色多普勒超声检测结果 ,早产窒息高胆红素血症患儿中有2例诊断为心肌炎患儿,10例诊断为亚临床心肌炎,16例疑诊心肌炎患者。结论高胆红素血症窒息早产患儿心肌细胞存在不同程度损伤,hs-CRP对新生儿心肌细胞损伤有一定预警价值。Objective To investigate clinical value of high-sensitivity C-reactive protein （hs-CRP） combined with myocardial enzyme detection in premature infant with asphyxia, and to provide scientific reference for clinical identification, diagnosis and treatment of premature infant. Methods A total of 80 premature infants with asphyxia and hyperbilirubinemia were divided by disease severity into mild asphyxia group （48 cases） and severe asphyxia group （32 cases）. There were 50 healthy newborn with physiologic jaundice as control group. Detection was made on serum total hilirubin （TBIL）, hs-CRP and myocardial enzyme detection for comparative analysis between the three groups. Results The mild and severe asphyxia groups had all higher aspartate aminotransferase （AST）, lactate dehydrogenase （LDH）, creatine kinase （CK）, creatine kinase isoenzyme（CK-MB）, ct-hydroxybutyrate dehydrogenase （α-HBD） and hs-CRP than the control group （P〈0.05）, and their TBIL were also higher than the control group （P〈0.05）. TBIL was positively correlated with hs-CRP. Clinical data and color Doppler ultrasound showed 2 cases with myocarditis, 10 eases with subclinical myocarditis and 16 cases with suspected myocarditis among premature infams with asphyxia and hyperbilirubinemia. Conclusion Due to different damage Of cardiac muscle cell in premature infants with asphyxia and hyperbilirubinemia, hs-CRP contains certain predictive value for neonatal myocardial cell damage.

关 键 词：超敏C反应蛋白 新生儿黄疸 心肌损伤 早产儿 窒息 

分 类 号：R722[医药卫生—儿科]