高胆红素血症患儿肝肾功能及心肌酶血清学水平表达及临床意义

Liver and kidney function and serological expression levels and clinical significance of myocardial enzymes in children patients with hyperbilirubinemia

目的:探讨高胆红素血症患儿肝肾功能及心肌酶血清学水平表达及临床意义。方法:选取2018年1月~2019年12月间收治的200例高胆红素血症患儿(观察组)作为研究对象,并纳入100例健康新生儿作为对照组。200例观察组患儿根据病情严重程度分组,比较各组患儿肝肾功能[丙氨酸氨基转移酶(ALT)、碱性磷酸酶(ALP)、肌酐(SCr)、血清β2微球蛋白(β2-MG)]、心肌酶[天冬氨酸氨基转移酶(AST)、肌酸激酶(CK)、肌酸激酶同工酶(CK-MB)、乳酸脱氢酶(LDH)]。采用pearson法分析各指标与患儿TBil的关系,比较不同病情严重程度患儿心电图异常情况,绘制ROC曲线分析心肌酶诊断心电图异常效能。结果:(1)观察组ALP、SCr、β2-MG均高于对照组,重度组和中度组ALT均高于对照组,重度组和中度组ALT、SCr均高于轻度组,重度组ALT、ALP、SCr、β2-MG均高于中度组;(2)观察组AST、CK、CK-MB、LDH均高于对照组,重度组和中度组AST、CK、CK-MB、LDH均高于轻度组,中度组AST、CK、CK-MB、LDH均高于轻度组;(3)Pearson相关分析显示,ALT、ALP、SCr、β2-MG、AST、CK、CK-MB、LDH与TBil呈正相关关系;(4)不同病情严重程度患儿心电图异常发生率对比差异有统计学意义,ROC曲线显示,各心肌酶指标水平均能诊断患儿心电图异常,其中CK诊断AUC最高。结论:高胆红素血症患儿肝肾功能、心肌酶指标水平与TBil水平关系密切,监测心肌酶水平有利于诊断心肌损害情况。

Objective To explore the liver and kidney function and serological expression levels and clinical significance of myocardial enzymes in children patients with hyperbilirubinemia.Methods 200 children patients with hyperbilirubinemia(observation group)admitted between January 2018 and December 2019 were selected as the research subjects,and 100 healthy neonates were included in control group.200 children patients in observation group were grouped according to the severity of the disease,and the liver and kidney function[alanine aminotransferase(ALT),alkaline phosphatase(ALP),creatinine(SCr),serumβ2 microglobulin β2-MG]and myocardial enzymes[aspartate aminotransferase(AST),creatine kinase(CK),creatine kinase isoenzyme(CK-MB),lactate dehydrogenase(LDH)]were compared in each group.Pearson method was used to analyze the relationship between each index and TBil.The electrocardiographic abnormalities were compared among children patients with different disease severity.ROC curve was drawn to analyze the efficacy of myocardial enzymes in the diagnosis of electrocardiographic abnormalities.Results(1)The ALP,SCr andβ2-MG in observation group were higher than those in control group,and the ALT in severe group and moderate group was higher than that in control group,and the ALT and SCr in severe group and moderate group were higher than those in mild group,and the ALT,ALP,SCr andβ2-MG in severe group were higher than those in moderate group.(2)The AST,CK,CK-MB and LDH in observation group were higher than those in control group,and the AST,CK,CK-MB and LDH in severe group and moderate group were higher than those in mild group,and the AST,CK,CK-MB and LDH in moderate group were higher than those in mild group.(3)Pearson correlation analysis showed that ALT,ALP,SCr,β2-MG,AST,CK,CK-MB and LDH were positively correlated with TBil.(4)There were statistically significant differences in the incidence rates of electrocardiographic abnormalities among children patients with different disease severity.ROC curve showed that all myocardial enzymes could diagnose electrocardiographic abnormalities in children patients,and the AUC value of CK diagnosis was the highest.Conclusion The liver and kidney function and myocardial enzymes in children patients with hyperbilirubinemia are closely related to TBil level,and monitoring the levels of myocardial enzymes is beneficial to the diagnosis of myocardial damage.