病理性黄疸对新生儿心肌影响的研究

A study on ffect of pathological jaundice on neonate's myocardium

目的探讨病理性黄疸对新生儿心肌的影响。方法根据治疗方法的不同,将研究对象分为治疗1组和治疗2组。回顾性分析两组新生儿血清总胆红素、心肌酶、心电图和超声心动图的变化。结果①发现两组新生儿的血清天门冬氨酸基转移酶、乳酸脱氢酶、肌酸磷酸激酶、肌酸激酶同工酶均有不同程度的升高,但两组之间血清各酶间比较无显著性差异(P>0.05);②两组新生儿心电图和超声心动图无明显异常改变,临床无明显心肌受损症状及体征;③治疗1组和治疗2组分别治疗7天后比较血清天门冬氨酸基转移酶、乳酸脱氢酶、肌酸磷酸激酶、肌酸激酶同工酶无显著性差异(P>0.05)。结论新生儿病理性黄疸对心肌无明显损害,无需常规使用保心肌治疗病理性黄疸。诊断新生儿心肌损伤仅依据其心肌酶谱值的增高是不够的,还要根据新生儿临床表现、心脏彩超、心电图改变等全面分析,综合判断。

Objective To study effect of pathological jaundice on neonate＇ s myocardium. Methods All neonates were diveded into treatment group 1 and treatment group 2. The changes of neonates in serum total bilirubin, myocardial enzymes, electrocardiogram, ultrasound cardiogram in two treatment groups were retrospectively analyzed. Results ①The serum AST, LDH, CPK, CK-MB of neonates in the two groups were higher at varied extent than normal, but there were no significant differences between the two groups（ all P 〉0.05） ;② No obvious abnormalities in electrocardiogram and ultrasound cardiogram were found in the two groups and no obvious symptoms and signs of myocardial damage in clinic were seen ;③After 7 days treatment, there were no significant differences in AST, LDH, CPK, CKMB of the neonates between the two treatment groups （all P 〉 0.05）. Conclusion Neonatal pathological jaundice doesn＇ t do serious harm to myocardium of the neonate. Routine myocardium protection treatment is not needed. The diagnosis of neonatal myocardial damage shouldn＇ t only depends up elevated myocardial enzyme values, but also comibines clinical manifestations of the neonate, abnormalities in ultrasound cardiogram and EEG to analyze all-round and judge synthetically.