新生儿高胆红素血症与心肌损害的关系探讨

Relationship of neonatal hyperbilirubinemia and myocardial injury

目的了解新生儿高胆红素血症对心功能的影响。方法对154例高胆红素血症和40非高胆红素血症的新生儿进行血胆红素、心肌肌钙蛋白Ⅰ(cTnⅠ)、肌酸激酶同功酶(CK-MB)测定。结果轻度组发病期和恢复期与对照组CK-MB差异均无统计学意义(均>0.05);轻度组恢复期cTnI与对照组差异无统计学意义(>0.05),发病期差异有统计学意义(<0.05)。中度组发病期CK-MB与cTnI与对照组差异均有统计学意义(均<0.05);恢复期CK-MB与cTnI与对照组差异均无统计学意义(均>0.05)。重度组发病期CK-MB与cTnI与对照组差异均有统计学意义(均<0.05);恢复期CK-MB与cTnI与对照组差异均无统计学意义(均>0.05)。结论高胆红素对新生儿心肌功能有暂时性损害。联合测定cTnⅠ、CK-MB水平可以监测高胆红素血症新生儿的心功能变化。

Objective To study the effect of neonatal hyperbilirubinemia on cardiac function.Methods One hundred and fifty-four neonates with hyperbilirubinemia were chosen as study group and 40 neonates with unhyperbilirubinemia were chosen and taken as control group.Serum urea bilirubin,cardiac troponin Ⅰand creatine kinase isoenzyme in both groups were determined.Results There was no significant difference in CK-MB of mild group and the control group（P〈0.05）.There was no significant difference in cTnI of mild group recovery phase and the control group（P〈0.05）,but there was a significant difference at onset phase（P〈0.05）.As for CK-MB and cTnI,the moderate group at onset phase was significantly different with the control group（P〈0.05）;but there was no significant difference at the recovery phase（P〈0.05）.There were significant differences in CK-MB and cTnI between the control group and severe group atthe onset phase（P〈0.05,） but there were no significant difference in CK-MB and cTnI between the control group and severe group at the recovery phase（P〈0.05.） Conclusions The high bilirubin of newborn has temporary damage to myocardial func-tion.Measurement of cTnⅠ and CK-MB content can monitor high-biliary changes in myocardial function of newborns.