新生儿高胆红素血症对心肌酶影响的研究  

Effects of neonatal hyperbilirubinemia on myocardial enzymes

作　　者：秦静 陈龙[2] 李龙海 侯常兰 杨采美 张金秀 杨珍珍 郭特鎏 QIN Jing;CHEN Long;LI Longhai;HOU Changlan;YANG Caimei;ZHANG Jinxiu;YANG Zhenzhen;GUO Teliu(Department of Pediatrics,Shoujia Hospital of Dujiangyan,Chengdu,Sichuan 611800,China;National Clinical Research Center for Child Health and Disease/Department of Neonatal Center,Children's Hospital of Chongqing Medical University,Chongqing 400015,China;Department of Pediatrics,Air Force Hospital of Western Theater Command,Chengdu,Sichuan 610061,China)

机构地区：[1]都江堰首嘉医院儿科,四川成都611800 [2]国家儿童健康与疾病临床医学研究中心/重庆医科大学附属儿童医院新生儿诊治中心,重庆400015 [3]西部战区空军医院儿科,四川成都610061

出　　处：《检验医学与临床》2023年第23期3438-3440,3444,共4页Laboratory Medicine and Clinic

基　　金：国家儿童健康与疾病临床医学研究中心临床研究项目(NCRC-2019-GP-13)。

摘　　要：目的研究新生儿高胆红素血症对心肌酶的影响。方法选择2021年1月至2022年12月都江堰首嘉医院和西部战区空军医院出生的高胆红素血症新生儿55例作为研究对象,根据病情严重程度分为重度黄疸组(25例)、轻度黄疸组(30例)。另选择同期出生的30例正常新生儿作为对照组。检测3组肌酸激酶(CK)、肌酸激酶同工酶(CKMB)、乳酸脱氢酶(LDH)和心肌肌钙蛋白I(cTnI)水平。检测轻度、重度黄疸组治疗后5 d CK、CKMB、LDH和cTnI水平。结果轻度、重度黄疸组CK、CKMB、LDH和cTnI水平均明显高于对照组,但轻度黄疸组低于重度黄疸组,差异均有统计学意义(P<0.05)。轻度、重度黄疸组患儿经蓝光和保护心肌治疗5 d后,血清总胆红素均降至221μmol/L以下,且CK、CKMB、LDH和cTnI水平均较治疗前明显降低,差异均有统计学意义(P<0.05);治疗后两组患儿CK、CKMB基本降至正常范围,差异无统计学意义(P>0.05),但轻度黄疸组LDH和cTnI水平降低程度比重度黄疸组更明显,且差异均有统计学意义(P<0.05)。结论新生儿高胆红素血症可以导致心肌细胞的损伤,早期、及时进行蓝光和保护心肌治疗能够有助于受损心肌细胞的康复。Objective To study the effects of neonatal hyperbilirubinemia on myocardial enzymes.Methods A total of 55 neonates with hyperbilirubinemia born in Dujiangyan Shoujia Hospital and Air Force Hospital of Western Theater Command from January 2021 to December 2022 were enrolled.According to the severity of the disease,they were divided into severe jaundice group(25 cases)and mild jaundice group(30 cases).Thirty normal neonates born during the same period were selected as the control group.The levels of creatine kinase(CK),creatine kinase isoenzyme(CKMB),lactate dehydrogenase(LDH)and cardiac troponin I(cTnI)in the 3 groups were detected.The levels of CK,CKMB,LDH and cTnI were detected 5 days after treatment in mild and severe jaundice groups.Results The levels of CK,CKMB,LDH and cTnI in the mild jaundice group and the severe jaundice group were significantly higher than those in the control group,but the mild jaundice group was lower than the severe jaundice group,the differences were statistically significant(P<0.05).After 5 days of blue light and myocardial protection treatment,serum total bilirubin decreased to less than 221μmol/L in mild and severe jaundice groups.The levels of CK,CKMB,LDH and cTnI in the 2 groups were significantly lower than those before treatment(P<0.05).After treatment,the CK and CKMB of the 2 groups basically decreased to the normal range,and the difference was not statistically significant(P<0.05),but the decreased degrees of LDH and cTnI in mild jaundice group were more obvious than severe jaundice group,and the differences were still statistically significant(P<0.05).Conclusion Neonatal hyperbilirubinemia can cause myocardial cell damage.Early and timely blue light and myocardial protection therapy can help the recovery of damaged myocardial cells.

关 键 词：新生儿 高胆红素血症 心肌酶 心肌细胞损伤 

分 类 号：R723[医药卫生—儿科]