新生儿缺氧缺血性脑病心肌损害的观察──心肌酶谱和心电图的改变

Enzymatic and ECG Changes in Neonates with Hypoxic-Ischaemic Encephalopathy

本文对２６例缺氧缺血性脑病（ＨＩＥ）新生儿和２８例健康新生儿（对照组）静脉血清肌酸激酶（ＣＫ）、乳酸脱氢酶（ＬＤＨ）、谷草转氨酶（ＧＯＴ）、α－羟丁酸脱氢酶（α－ＨＢＤＨ）于生后３天内进行检测并做心电图以观察ＨＩＥ新生儿心脏受损的情况。结果表明，血清ＣＫ、ＬＤＨ、ＧＯＴ、α－ＨＢＤＨ水平ＨＩＥ组明显高于对照组（ｐ＜０．０１），重度ＨＩＥ组显著高于中度ＨＩＥ组（ｐ＜０．０１），中度ＨＩＥ组高于轻度ＨＩＥ组（ｐ＜０．０１）。ＨＩＥ组异常心电图百分率高于正常对照组，但无统计学差异（ｐ＞０．０５）。提示ＨＩＥ新生儿生后早拥有血清心肌酶活性和心电图的异常改变，似可作为临床早期初步筛查ＨＩＥ新生儿心脏受损及估价其严重程度的指标。

To investigate whether the myocardium is affected or not, the serum activities fo creatine kinase(CK),lactic dehydrogenase(LDH),glutamic oxaloacetic transaminase(GOT)、α-hydroxybutyric dehydrogenase(αa-HBDH)were studied prospectively in 26 neonates with HIE and 28 healthy newborns for control durig the first 3 days of life. Mean serum CK、LDH、GOT and α-HBDH activities were significantly elevated in the neonates with HIE compared with control group(p<0.01).The infants with severe HIE had higher serum activities of CK.LDH. GOT and α-HBDH than those with moderate HIE(p<0. 01).The infants with moderate HIE had higher serum activities of CK.LDH. GOT and α-HBDH than those with mild HIE (p<0. 01). Meanwhile electrocardiographic abnormalities were found in 8 of 15 infants with HIE (53.33%),whereas only 5 of 16 newborns in control group(31. 25%). The results suggest that myocardial involvement in the newborn with HIE is associated with some enzpmes release and ECG changes. The above enzymes and ECG can be used to screen myocardial damage in the early days of neonates with HIE.