摘要
评价血浆心肌肌钙蛋白I（cTnI）、肌酸激酶心型同工酶质量（CK-MB-mass）、肌酸激酶心型同工酶质量/肌酸激酶活性的比值（CK-MBmass/CK）对围产期窒息后心肌损伤诊断价值,对71例围产期窒息新生儿及27例对照组新生儿生后6～48小时血浆cTnI、CK-MBmass及CK水平进行测定并计算CK-MBmass/CK比值,运用Wilcoxon秩和检验等方法进行分析。结果显示:（1）新生儿窒息伴胎儿窘迫组（23例）cTnI、CK-MBmass、CK均显著高于对照组（27例）;新生儿窒息伴胎儿窘迫组CK-MB-mass、CK显著高于单纯窘迫组（38例）;单纯窒息组（10例）与对照组相比,仅CK-MB-mass/CK明显降低,其它指标差异无显著性。（2）围产期窒息组重度心脏损害患儿（8例）cTnI、CK-MBmass、CK均明显高于该组无重度心脏损害患儿（63例）。（3）重度窒息组（17）例仅CK-MBmass、CK明显高于轻度窒息组（16例）。因此,新生儿严重缺氧时,血浆cTnI、CK-MBmass、CK均明显增高,表明存在心肌损伤。CTnI虽对心肌损伤有高度特异性,但敏感性低于CK-MBmass、CK,且受胎龄影响;在判断早产儿心肌损伤时有一定的局限性。CK-MBmass/CK比值不宜作为围产期窒息后心肌损伤的生化指标。
To assess the diagnostic value of plasma cardiac troponin I(cTnI), creatine kinase MB isoenzyme mass (CK-MBmass) and CK-MBmass/CK ratio to myocardial injury post perinatal asphyxia, seventy-one neonates with perinatal asphyxia were studied prospectively. Twenty-seven neonates without perinatal asphyxia were considered as the control group. Concentration of cTnI, CK-MBmass and CK was measured in 6 ~ 48 hours after birth, and CK-MBmass/CK ratio was calculated. Results were analyzed with Wilcox-on rank sum test. Results (1) The concentrations of cTnI, CK-MBmass and CK were significantly higher in asphyxiated neonates with fetal distress (n = 23) than in control group (n = 27). The concentrations of CK- MBmass and CK were significantly higher in asphyxiated neonates with fetal distress than in non-asphyxiated neonates with fetal distress (n = 38). The CK-MBmass/CK ratio was significantly lower in asphyxiated neonates without fetal distress (n = 10) than in control group, and other index did not differ significantly between groups. (2) In the group of perinatal asphyxia, the concentrations of cTnl, CK-MBmass and CK in neonates with severe heart involvement (n = 8) were significantly higher than that of other neonates (n = 63). (3) There was statistically significant difference for CK-MBmass and CK between the group of neonates with severe asphyxia (n = 17) and the group of neonates with mild asphyxia (n= 16). In conclusion: myocardial injury had occurred when the concentrations of cTnI, CK-MBmass and CK were significantly high in severe perinatal asphyxia. Though elevations of cTnI have superior specificity for detecting myocardial injury, the sensitivity of cTnI may be poorer than that of CK-MBmass and CK, and there was a positive correlation between cTnI and gestational age, the diagnostic value for cTnl to myocardial injury post preterm was reduced. CK-MBmass/CK ratio isn't suitable for diagnosis of myocardial injury post perinatal asphyxia.
出处
《新生儿科杂志》
2002年第3期106-109,共4页
The Journal of Neonatology
