心肌酶谱早期诊断新生儿窒息后心肌损伤的研究

Study on Early Diagnosis for Myocardial Damage with Cardiac Enzyme in Newborns with Perinatal Asphyxia

目的评估心肌酶谱早期诊断新生儿窒息后心肌损伤的价值。方法采用前瞻性病例对照研究的方法,42例窒息新生儿作为病例组,42例健康新生儿作为健康对照组。临床表现、心电图、心脏彩超、心肌酶谱(CK-MB和cTnT)测定用来评估窒息后心肌损伤。结果在病例组,共有26例(26/42)窒息患儿发生心肌损害,而健康对照组仅2例发生ECG异常。在病例组,cTnT和CK-MB水平均较健康对照组明显升高(P<0.05),cTnT诊断的敏感度和特异度均较CK-MB为高(P<0.05)。而且cTnT水平同窒息新生儿心肌损伤的严重程度和预后呈明显的相关性。结论 cTnT不仅可以早期诊断窒息新生儿的心肌损伤,而且还可以评估其损伤的严重程度.

Objective To evaluate the value of cardiac enzyme levels in early diagnosis of myocardial damage in newborns with perinatal asphyxia. Methods 42 cases of newborns with perinatal asphyxia were enrolled as case group and 42 healthy newborns were used as control group.Myocardial dysfunction was assessed using clinical presentation,electrocardiography（ECG）,echocardiograpy and cardiac enzymes including cardiac troponin-T（cTnT） and creatine kinase-MB（CK-MB）.Results Among the 42 cases 26 had evidence of myocardial damage while 2 newborn in the control group had abnormal ECG.Cardiac enzymes were increased significantly in newborns with perinatal asphyxia.The mean level of cTnT in case and control groups were（0.24±0.13） ng/ml and（0.002±0.001） ng/ml while CK-MB level was（127.3±82.6） IU/L and（30.4±18.7） IU/L,respectively（P0.05）.cTnT had higher sensitivity and specificity as compared to CK-MB（P0.05）.Moreover,cTnT level was correlated well with severity and outcome in newborns with perinatal asphyxia.Conclusion cTnT assay has the value of early diagnosis and it is useful in evaluating the severity of myocardial damage and outcome in perinatal asphyxia.