新生儿高胆红素血症对心肌损伤标记物水平及心率变异性的影响  

Clinical study on the effect of neonatal hyperbilirubinemia on markers of myocardial injury,heart rate variability and early diagnosis

作　　者：唐骏 陈淑敏 张玉桃 陈海业 张文铭 TANG Jun;CHEN Shu-min;ZHANG Yu-tao;CHEN Hai-ye;ZHANG Wen-ming(Guangzhou Liwan District Maternal and Child Health Care Center,Guangdong Guangzhou 510100,China)

机构地区：[1]广州市荔湾区妇幼保健院,广东广州510100

出　　处：《江苏预防医学》2020年第3期297-299,共3页Jiangsu Journal of Preventive Medicine

摘　　要：目的探讨新生儿胆红素血症对心肌损伤标志物水平及心率变异性的影响。方法新生儿高胆红素血症患儿根据血清总胆红素(TBIL)水平分为轻、中、重度3组,各选择60例,同期选择健康足月新生儿60名作为对照组。比较各组心肌损伤标志物水平、心电图指标,并分析相关性。结果新生儿高胆红素血症患儿轻、中、重度组TBIL、间接胆红素(IBIL)水平均高于对照组,心肌损伤标志物CK-MB、cTnI水平均高于对照组,以上差异均有统计学意义(P值均<0.05),3组间各指标水平差异均有统计学意义(P值均<0.05)。随着TBIL浓度升高,患儿心电图及动态心电图各指标水平均降低;与对照组相比,轻、中、重度组心率变异性各指标水平均不同程度降低,其中重度组各指标水平均低于其他组别(P值均<0.05)。Pearson相关性检验分析结果表明,cTnI与TBIL呈正相关(P<0.05),SDNN与TBIL呈负相关(P<0.05)。结论高胆红素血症新生儿心肌损伤标志物水平升高,心率变异性降低,其中cTnI、SDNN与TBIL可作为早期诊断的重要指标。Objective To investigate the effects of neonatal bilirubinemia on the myocardial injury markers levels and heart rate variability.Methods The neonates with hyperbilirubinemia were divided into mild,moderate and severe groups according to serum total bilirubin(TBIL)levels,with 60 cases in each group,and 60 healthy full-term newborns were selected as the control group at the same time.The markers of myocardial injury and electrocardiogram(ECG)were compared,the correlation was analyzed.Results The levels of TBIL and indirect bilirubin(IBIL)in mild,moderate and severe groups were higher than those in the control group,and the myocardial injury marker levels of CK-MB and cTnI were higher than those in the control group,all above differences were statistically significant(all P<0.05),and the differences of all indices among 3 groups were statistically significant(P<0.05).With the increase of TBIL concentration,the levels of ECG and dynamic electrocardiogram indices in children decreased.Compared with the control group,the levels of heart rate variability in mild,moderate and severe groups decreased in various degrees,and the levels of each index in severe group were lower than those in other groups(all P<0.05).Pearson correlation test showed that there was a positive correlation between cTnI and TBIL(P<0.05);SDNN was negatively correlated with TBIL(P<0.05).Conclusion The myocardial injury markers in neonates with hyperbilirubinemia increased,while the heart rate variability decreased.The indices such as cTnI and SDNN could be used as an important index for early TBILdiagnosis.

关 键 词：高胆红素血症 新生儿 心肌损伤标记物 心率变异性 

分 类 号：R542.2[医药卫生—心血管疾病]