肺动脉高压新生儿心肌损伤与心肌酶谱、肌钙蛋白水平的相关性研究  

Correlations between myocardial injury and the myocardial enzymes activities and cTnⅠ level in neonates with pulmonary hypertension

作　　者：宁亚灵[1] 杨青[1] 杨茜芸 鲁聪[2] Ning Yaling;Yang Qing;Yang Qianyun;Lu Cong(Department of Paediatrics,The Seventh People＇ s Hospital,Dingzhou 073000,China;Children＇s Intensive Care Unit,Beijing Children＇s Hospital,Beijing 100032,China)

机构地区：[1]河北省第七人民医院儿科,定州073000 [2]北京儿童医院儿童重症监护室,北京100032

出　　处：《广西医科大学学报》2018年第8期1072-1075,共4页Journal of Guangxi Medical University

基　　金：河北省保定市科学技术研究与发展指导计划课题资助项目(No.14ZF079)

摘　　要：目的:探讨肺动脉高压新生儿心肌损伤与心肌酶谱、肌钙蛋白水平的关系。方法:选取2014年1月至2016年1月本院收治的肺动脉高压新生儿45例(A组)与非肺动脉高压新生儿45例(B组)为研究对象,A组根据症状给予纠酸、吸氧、酚妥拉明或多巴胺等常规对症治疗。分别于出生后1d、7d,检测两组血清心肌酶活性、肌钙蛋白-Ⅰ(cTnⅠ)、氧分压(PaO_2)、肺动脉收缩压(PASP),并探讨PaO_2、PASP与血清心肌酶活性指标、cTnⅠ的相关性。结果:两组出生后7d,PASP及血清肌酸激酶同工酶(CK-MB)、cTnⅠ、肌酸激酶(CK)、α-羟丁酸脱氢酶(α-HBDH)、乳酸脱氢酶(LDH)水平均显著低于出生后1d(均P<0.05),而PaO_2显著高于出生后1d。A组出生后1d,PASP及血清CK-MB、cTnⅠ、CK、α-HBDH、LDH水平均显著高于B组(均P<0.05),PaO_2显著低于B组(P<0.05)。直线相关性分析结果显示,A组出生后1d,PaO_2与CK-MB、cTnⅠ均呈负相关关系,PASP与CK-MB、cTnⅠ均呈正相关关系(P<0.05)。B组出生后1d,PaO_2、PASP与CK-MB、cTnⅠ无明显相关关系(P>0.05)。结论:肺动脉高压新生儿可发生心肌损伤,心肌损伤时,CK-MB、cTnⅠ水平与PaO_2、PASP有一定关系,而肺动脉压力高低与心肌损伤程度无相关关系,可为临床诊断肺动脉高压新生儿心肌损伤提供一定依据。Objective：To investigate the associations between myocardial injury and the myocardial enzymes activities and cTnⅠ level in neonates with pulmonary hypertension.Methods：A total of 90 neonates with pulmonary hypertension（n=45,group A）or without pulmonary hypertension（n=45,group B）were enrolled in this study.Serum myocardial enzymes activities,cardiac troponin-Ⅰ（cTnⅠ）,oxygen partial pressure（PaO2）and pulmonary artery systolic blood pressure（PASP）were detected on day 1 and 7 after birth.The correlations among PaO2,PASP and serum myocardial enzymes activities and cTnⅠ were analyzed.Results：After 7 days of birth,the PASP,CK-MB,cTnⅠ,CK,α-HBDH and LDH in both groups were significantly decreased,while the PaO2 was increased（P〈0.05）.On day 1 after birth,the PASP and the serum levels of CK-MB,cTnⅠ,CK,α-HBDH and LDH in group A were significantly higher than those in the group B,whereas the PaO2 was lower（P〈0.05）.The PaO2 was negatively correlated with CK-MB and cTnⅠ after 1 day of birth in group A,and PASP was positively correlated with CK-MB and cTnⅠ（P 〈0.05）.There was no correlation between PaO2,PASP and the levels of CK-MB and cTnⅠ in group B after birth（P〉0.05）.Conclusion：The newborns with pulmonary hypertension might experience myocardial injury.The levels of CK-MB and cTnⅠ were associated with PaO2 and PASP when myocardial injury occurred.However,there was no correlation between the pulmonary artery pressure and the degree of myocardial injury.

关 键 词：心肌酶谱 肌钙蛋白 新生儿 心肌损伤 

分 类 号：R544.1[医药卫生—心血管疾病]