窒息新生儿多脏器功能损害的临床分析

Clinical Analysis on Multi-organ Damage in Asphyxial Newborn

目的探讨窒息新生儿的心、肝、肾功能损害情况。方法选择62例出生后窒息的新生儿,其中轻度窒息51例,重度窒息11例。另选择20例健康新生儿作为对照组。检测并比较3组新生儿的心、肝、肾功能。结果对照组新生儿血清天冬氨酸氨基转移酶(AST)、肌酸磷酸激酶(CPK)、肌酸激酶同工酶(CK-MB)、乳酸脱氢酶(LDH)、肌酐(CREA)水平分别为(39±21)U/L、(199±49)U/L、(32±17)U/L、(214±104)U/L和(51±20)μmol/L,轻度窒息组上述指标水平分别为(99±42)U/L、(1 162±321)U/L、(78±46)U/L、(732±329)U/L和(91±26)μmol/L,重度窒息组上述指标水平分别为(140±115)U/L、(2 989±855)U/L、(1 157±988)U/L、(1 157±988)U/L和(125±63)μmol/L,3组新生儿上述指标水平组间两两比较,差异均有统计学意义(P<0.01)。对照组新生儿血清总胆红素(TBIL)水平〔(125±53)μmol/L〕与轻、重度窒息组〔(89±40)μmol/L和(69±31)μmol/L〕比较,差异均有统计学意义(P<0.01)。结论血清AST、CPK、CK-MB、LDH、TBIL、CREA水平检测对新生儿窒息早期心、肝、肾功能损害的评价有重要的意义。

Objective To discuss the functional damages of the heart,liver and kidney in asphyxia newborn.Methods Totally 62 asphyxial newborns were chosen,of which 51 were with mild asphyxia and 11 with serious asphyxia.And 20 normal newborns were chosen as controls.The functions of the heart,liver and kidney in the three groups were measured and compared.Results The levels of serum aspartate aminotransferase(AST),creatine phosphokinase(CPK),creatine kinase-M(CK-MB),lactate dehydrogenase(LDH),and creatinine(CREA) in the control group were respectively(39±21)U/L,(199±49)U/L,(32±17)U/L,(214±104)U/L,and(51±20)μmol/L;while those indexes in the mold asphyxia group were(99±42)U/L,(1162±321)U/L,(78±46)U/L,(732±329)U/L,(91±26)μmol/L;and in the serious asphyxia group were(140±115)U/L,(2 989±855)U/L,(1 157±988)U/L,(1 157±988)U/L,(125±63)μmol/L.There were significant differences in the level of serum AST,CPK,CK-MB,LDH,and CREA between each two groups(P<0.01).The level of total bilirubin(TBIL)((125±53)μmol/L)in the control group was significantly different from those in the asphyxia groups((89±40)μmol/L and(69±31)μmol/L)(P<0.01).Conclusion The detection of serum AST,CPK,CK-MB,LDH,TBIL,and CREA is of important significance to evaluate multi-organ damages of asphyxial newborns.