新生儿溶血病患儿心肌酶谱、肌钙蛋白T及血清神经元特异性烯醇化酶检测的临床意义  

Clinical significance of detection of myocardial enzymes, troponin T and serum neuron specific enolase in hemolytic disease of the newborns

作　　者：林静[1] 张建钫[1] 周欢[1] LIN Jing;ZHANG Jian-fang;ZHOU Huan(Department of Clinical Laboratory,Fujian Provincial Hospital,Fuzhou 350001,China)

机构地区：[1]福建省立医院检验科

出　　处：《中国当代医药》2019年第20期12-15,共4页China Modern Medicine

摘　　要：目的通过对新生儿溶血病(HDN)患儿心肌酶谱、肌钙蛋白T(cTnT)及血清神经元特异性烯醇化酶(NSE)的检测,探讨心肌酶谱、cTnT、NSE在HDN引起心脏、神经系统功能改变中的临床意义。方法选择2016年6月~2017年6月我院经临床和实验室确诊的336例HDN患儿,根据总胆红素(TBIL)水平将HDN患儿分为A组(46例)、B组(66例)、C组(169例)、D组(55例),同时选取40例正常足月新生儿作为对照组。检测各组的TBIL、间接胆红素(IBIL)、心肌酶谱[天门冬酸氨基转换酶(AST)、磷酸肌酸激酶(CK)、磷酸肌酸激酶同工酶(CK-MB)、乳酸脱氢酶(LDH)、α-羟丁酸脱氢酶(α-HBDH)]、cTnT以及NSE水平;分析各指标与TBIL、IBIL之间的相关性。结果A、B、C、D组的TBIL、IBIL水平均高于对照组,差异有统计学意义(P<0.05);A、B、C、D组的TBIL、IBIL水平比较,差异有统计学意义(P<0.05);A、B、C、D组的AST、LDH、α-HBDH、NSE水平均高于对照组,差异有统计学意义(P<0.05);A、B、C、D组的AST、LDH、α-HBDH、NSE水平比较,差异无统计学意义(P>0.05);A、B组的CK、CK-MB水平均高于对照组,差异有统计学意义(P<0.05);C、D组的CK、cTnT水平与对照组及A组比较,差异有统计学意义(P<0.05);C组的CK-MB水平高于对照组,差异有统计学意义(P<0.05);D组的CK-MB水平低于A组和B组,差异有统计学意义(P<0.05)。AST、LDH、α-HBDH及NSE与TBIL、IBIL不相关(P>0.05);CK与TBIL、IBIL均成负相关(r=-0.18、-0.17,P<0.05);CK-MB与TBIL、IBIL均成负相关(r=-0.19、-0.20,P<0.05);cTnT与TBIL、IBIL均成正相关(r=0.15、0.16,P<0.05)。结论HDN患儿存在心肌酶谱、cTnT、NSE的改变,提示患儿可能存在心功能、神经系统受损,但与胆红素水平无明显线性相关性。Objective To detect myocardial enzymes,troponin T (cTnT) and serum neuron specific enolase (NSE) in children with hemolytic disease of the newborn (HDN),and to investigate the clinical significance of myocardial enzymes,cTnT and NSE in HDN induced changes of cardiac and nervous system functions.Methods A total of 336 children with HDN diagnosed by clinical and laboratory in our hospital from June 2016 to June 2017 were selected.Children with HDN were divided into group A (46 cases),group B (66 cases) and group C (169 cases),and group D (55 cases) according to total bilirubin (TBIL) level.At the same time,40 normal newborns were selected as the control group.The levels of TBIL,indirect bilirubin (IBIL),myocardial enzymes (aspartic acid amino-converting enzyme [AST],creatine kinase [CK],creatine kinase isoenzyme [CK-MB],lactate dehydrogenase [LDH],α-hydroxybutyrate dehydrogenase [α-HBDH]),cTnT,and NSE were detected among the groups.The correlation between each indicator and TBIL,IBIL was analyzed.Results The levels of TBIL and IBIL in group A,B,C and D were higher than those in the control group,and the differences were statistically significant (P<0.05).The differences of TBIL and IBIL levels in group A,B,C and D were statistically significant (P<0.05).The levels of AST,LDH,α-HBDH and NSE in group A,B,C and D were higher than those in the control group,and the differences were statistically significant (P<0.05).There were no significant differences in AST,LDH,α-HBDH and NSE levels among group A,B,C and D (P>0.05).The levels of CK and CK-MB in group A and group B were higher than those in the control group,and the differences were statistically significant (P<0.05).The levels of CK and cTnT in group C and group D were significantly different from those in control group and group A (P<0.05).The level of CK-MB in group C was higher than that in the control group,and the difference was statistically significant (P<0.05).The level of CK-MB in group D was lower than that in group A and group B,and the difference was

关 键 词：新生儿 高胆红素血症 心肌酶谱 肌钙蛋白T 神经元特异性烯醇化酶 

分 类 号：R722.1[医药卫生—儿科]