新生儿窒息后血清CK-MB、CT-1及H-FABP判断心肌损伤的价值  

The value of serum CK-MB,CT-1 and H-FABP in diagnosing myocardial injury after neonatal asphyxia

作　　者：康静 王斐 靳秀花[1] 李存桂[1] 张艳荣[1] KANG Jing;WANG Fei;JIN Xiuhua;LI Cungui;ZHANG Yanrong(Department of Neonatology, Qinghai Red Cross Hospital, Xining 810000, China)

机构地区：[1]青海红十字医院新生儿科,青海西宁810000

出　　处：《西部医学》2022年第7期1069-1072,共4页Medical Journal of West China

基　　金：青海省卫生系统指导性计划课题(2018-wjzdx-127)。

摘　　要：目的 探讨新生儿窒息后血清肌酸激酶同工酶(CK-MB)、心肌营养素-1(CT-1)及心性脂肪酸结合蛋白(H-FABP)判断心肌损伤的价值。方法 选取2018年1月~2019年12月我院收治的窒息新生儿98例为观察组,其中有心肌损伤者31例,同时选取健康新生儿50例为对照组,比较两组患儿血清CK-MB、CT-1及H-FABP水平。结果 两组性别、胎龄、体质量及身长比较差异无统计学意义(P>0.05);观察组出生后5 min Apgar评分(5.30±0.82)明显低于对照组(9.40±0.32)(P<0.05)。观察组血清CK-MB、CT-1及H-FABP分别为(6.62±1.31)ng/mL、(68.46±18.84)ng/L和(21.03±8.11)ng/mL,明显高于对照组(P<0.05);观察组有心肌损伤患儿血清CK-MB、CT-1及H-FABP分别为(7.01±1.22)ng/mL、(78.11±12.03)ng/L和(30.45±9.54)ng/mL,明显高于无心肌损伤患儿(P<0.05);血清CK-MB、CT-1及H-FABP判断心肌损伤的ROC曲线下面积分别为0.629、0.815和0.862,其中CT-1及H-FABP的ROC曲线下面积高于CK-MB(均P<0.05)。结论 CK-MB、CF-1及H-FABP在判断新生儿窒息后心肌损伤中有一定应用价值,其中CF-1及H-FABP价值较高。Objective To investigate the value of serum creatine kinase isoenzyme(CK-MB),cardiotrophin-1(CT-1)and heart fatty acid binding protein(H-FABP)in determining myocardial injury after neonatal asphyxia.Methods From January 2018 to December 2019,98 cases of neonatal asphyxia(observation group),including 31 cases with myocardial injury,and 50 cases of healthy newborns were selected as the control group.The serum CK-MB,CT-1 and H-FABP levels were detected.Results There was no significant difference in gender,gestational age,body weight,and length between the observation group and the control group(P>0.05).The Apgar score(5.30±0.82)of the observation group at 5 min after birth was significantly lower than that of the control group(9.40±0.32)(P<0.05).The serum CK-MB,CT-1 and H-FABP in the observation group were(6.62±1.31)ng/mL,(68.46±18.84)ng/L and(21.03±8.11)ng/mL,which were significantly higher than those in the control group(P<0.05).The serum CK-MB,CT-1 and H-FABP in children with myocardial injury of the observation group were(7.01±1.22)ng/mL,(78.11±12.03)ng/L and(30.45±9.54)ng/mL,which were significantly higher than those of children without myocardial injury(P<0.05);The area under ROC curve of serum CK-MB,CT-1 and H-FABP in diagnosis of myocardial injury was 0.629,0.815 and 0.862,respectively(P<0.05).The area under ROC curve of CT-1 and H-FABP was higher than that of CK-MB(P<0.05).Conclusion CK-MB,CT-1 and H-FABP have certain application value in judging myocardial injury after neonatal asphyxia,among which CT-1 and H-FABP have higher value.

关 键 词：新生儿窒息 心肌损伤 血清肌酸激酶同工酶 心肌营养素-1 心性脂肪酸结合蛋白 

分 类 号：R722.12[医药卫生—儿科]