胎盘早剥早产儿脐血心肌型脂肪酸结合蛋白水平与心肌损伤的关系研究  

Relationship between heart fatty acid-binding protein in cord blood and myocardial injury in premature infants with placental abruption

作　　者：杨慧 王芳会[2] 郝莉霞[3] 朱航 李怡凡 赵奇萍 YANG Hui;WANG Fang-hui;HAO Li-xia;ZHU Hang;LI Yi-fan;ZHAO Qi-ping(Department of Pediatrics,215 Hospital of Shanxi Nuclear Industry,Xianyang 712000,Shanxi Province;Department of Pediatrics,the First Affiliated Hospital of Xi′an Jiaotong University,Xi′an 710061,Shanxi Province;Department of Pediatrics,Affiliated Hospital of Yan′an University,Xi′an 710061,Shanxi Province)

机构地区：[1]陕西省核工业二一五医院儿科,陕西咸阳712000 [2]西安交通大学第一附属医院新生儿科,西安710061 [3]陕西延安大学附属医院新生儿科,延安716000

出　　处：《中国优生与遗传杂志》2020年第12期1491-1494,共4页Chinese Journal of Birth Health & Heredity

基　　金：二一五医院2016年院级科研立项项目(院科2016-7)。

摘　　要：目的探究胎盘早剥(PA)早产儿脐血血清心肌型脂肪酸结合蛋白(H-FABP)水平与心肌损伤的关系。方法选取本院2016年8月~2020年7月诊治的PA早产儿125例进行研究,按患儿出生14d内有无心肌损伤将其分为心肌未损伤组(56例)和心肌损伤组(69例)。比较两组基本资料;利用胶乳增强免疫比浊法、免疫抑制法、化学发光法分别检测脐血血清H-FABP、肌酸激酶同工酶MB(CK-MB)、心肌肌钙蛋白I(cTnI)水平;Pearson法分析PA并发心肌损伤早产儿脐血血清H-FABP水平与CK-MB、cTnI的相关性;应用受试者工作特征曲线(ROC曲线)评价脐血血清H-FABP、CK-MB、cTnI水平对PA早产儿心肌损伤的诊断价值;Logistic回归分析PA早产儿发生心肌损伤的影响因素。结果心肌损伤组早产儿超声心动图异常比例、心电图异常比例、心音减弱比例、心律失常比例、早产儿脐血血清H-FABP、CK-MB、cTnI水平均明显高于心肌未损伤组(P<0.05);PA并发心肌损伤早产儿脐血血清H-FABP水平与CK-MB、cTnI均呈正相关(P<0.05);脐血血清H-FABP诊断PA早产儿心肌损伤的曲线下面积(AUC)为0.868,截断值为23.44 ng/mL,灵敏度为84.1%,特异度为91.1%;血清H-FABP与CK-MB、cTnI联合诊断PA早产儿心肌损伤的AUC为0.926,其灵敏度、特异度分别为91.3%、89.3%;H-FABP、CK-MB、cTnI均是影响PA早产儿发生心肌损伤的危险因素(P<0.05)。结论发生心肌损伤的PA早产儿脐血血清H-FABP水平明显升高,检测脐血H-FABP对PA早产儿心肌损伤有一定诊断价值,且H-FABP与CK-MB、cTnI联合可更好地筛查PA并发心肌损伤早产儿。Objective:To explore the relationship between the level of serum heart fatty acid-binding protein(H-FABP)and myocardial injury in premature infants with placental abruption(PA).Methods:From August 2016 to July 2020,125 cases of PA premature infants diagnosed and treated in our hospital were selected and divided into non myocardial injury group(56 cases)and myocardial injury group(69 cases)according to whether there was myocardial injury within 14 days after birth.The basic data of the two groups were compared;the levels of serum H-FABP,creatine kinase MB(CK-MB)and cardiac troponin I(cTnI)in cord blood were detected by latex enhanced immunoturbidimetry,immunosuppression and chemiluminescence;Pearson method was used to analyze the correlation of serum H-FABP level with CK-MB and cTnI in premature infants with PA complicated with myocardial injury;receiver operating characteristic curve(ROC curve)was used to evaluate the diagnostic value of serum H-FABP,CK-MB and cTnI levels in premature infants with PA;Logistic regression analysis was used to analyze the influencing factors of myocardial injury in premature infants with PA.Results:The proportions of abnormal echocardiography,abnormal ECG,decreased heart sound,arrhythmia,levels of H-FABP,CK-MB,cTnI in cord blood of premature infants in myocardial injury group were significantly higher than those in non myocardial injury group(P<0.05);the levels of serum H-FABP in cord blood of premature infants with PA complicated with myocardial injury were positively correlated with CK-MB and cTnI(P<0.05);the area under the curve(AUC)of cord blood serum H-FABP in the diagnosis of myocardial injury in premature infants with PA was 0.868,the cut-off value was 23.44 ng/mL,the sensitivity was 84.1%,and the specificity was 91.1%;the AUC of H-FABP combined with CK-MB and cTnI in the diagnosis of myocardial injury in PA premature infants was 0.926,and the sensitivity and specificity were 91.3%and 89.3%,respectively;H-FABP,CK-MB and cTnI were risk factors of myocardial injury in PA premat

关 键 词：胎盘早剥 脐血 心肌损伤 早产儿 心肌型脂肪酸结合蛋白 

分 类 号：R722.6[医药卫生—儿科]