血清心肌酶谱联合胆红素对足月新生儿心肌损害的诊断价值  

The diagnostic value of serum myocardial enzyme spectrum combined with bilirubin for myocardial damage in full-term newborns

作　　者：刘蕾[1] LIU Lei(Department of Pediatrics,Danyang Maternal and Child Health Hospital,Danyang 212300,Jiangsu,China)

机构地区：[1]丹阳市妇幼保健院儿科,江苏丹阳212300

出　　处：《吉林医学》2024年第12期2907-2910,共4页Jilin Medical Journal

基　　金：丹阳市科技创新专项资金重点研发计划(社会发展)项目[项目编号:SSF202213]。

摘　　要：目的:探讨血清心肌酶谱联合胆红素对足月新生儿心肌损害的临床诊断效果。方法:选取收治的足月心肌损害新生儿50例作为心肌损害组,另选取50例同期健康新生儿作为无损害组,对所有新生儿行血清心肌酶谱各指标水平检测及胆红素水平检查,并分析其联合检测对新生儿心肌损害的诊断效能。结果:心肌损害组血清肌酸激酶(CK)、乳酸脱氢酶(LDH)、谷草转氨酶(AST)、肌酸激酶同工酶(CK-MB)以及总胆红素(TBIL)水平均明显高于对照组(P<0.05);多因素Logistic回归分析结果显示,LDH、AST以及TBIL为新生足月婴儿发生心肌损害的独立危险因素;血清LDH水平预测足月新生儿心肌损害的AUC值为0.904,曲线下面积为0.828~0.954,血清AST水平预测足月新生儿心肌损害的AUC值为0.881,曲线下面积为0.801~0.937,血清TBIL水平预测新生足月幼儿心肌损害的AUC值为0.882,曲线下面积为0.802~0.938,联合预测足月新生儿心肌损害的AUC值为0.994,曲线下面积为0.952~1.000。结论:血清心肌酶谱相关指标联合胆红素对足月新生儿心肌损害的诊断更加准确,可为临床尽早发现及制定防治方案提供依据。Objective To investigate the clinical diagnostic effect of serum myocardial enzyme profile combined with bilirubin on myocardial damage in full-term neonates.Method A total of 100 full-term neonates with suspected myocardial damage admitted to our hospital were divided into myocardial damage group(n=50)and no myocardial damage group(n=50).All neonates were tested for serum myocardial enzyme pattern and bilirubin levels.The diagnostic efficacy of the combined test on neonatal myocardial damage was analyzed.Results The levels of serum CK,LDH,AST,CK-MB and TBIL in myocardial injury group were significantly higher than those in control group(P<0.05).With serum CK,LDH,AST,CK-MB and TBIL levels as independent variables and myocardial damage as dependent variables,the multivariate Logistic regression analysis was carried out.The results showed that LDH,AST and TBIL were independent risk factors for myocardial damage in newborn full-term infants.The AUC value and area under the curve of serum LDH level for predicting myocardial damage of newborn and full-term infants were 0.904 and 0.828~0.954,and the AUC value and area under the curve of serum AST level for predicting myocardial damage of newborn and full-term infants were 0.881 and 0.801~0.937.Serum TBIL level predicted the AUC value of neonatal full-term infant myocardial damage was 0.882,and the area under the curve was 0.802~0.938;combined predicted the AUC value of neonatal full-term infant myocardial damage was 0.994,and the area under the curve was 0.952~1.000.Conclusion Serum myocardial enzyme profile related indexes combined with bilirubin are more accurate in the diagnosis of myocardial damage in full-term neonates,which can provide evidence for early clinical detection and prevention and treatment.

关 键 词：血清心肌酶谱 胆红素 足月新生儿 心肌损害 诊断价值 

分 类 号：R722[医药卫生—儿科]