高间接胆红素血症新生儿治疗前后心肌损伤标志物变化观察

Observation of the changes of myocardial damage markers in neonates with indirect hyperbilirubinemia pre and post treatment

目的观察高间接胆红素血症新生儿心肌损伤标志物治疗前后变化,探讨高间接胆红素血症新生儿是否存在心肌损伤。方法分别测定30例无黄疸新生儿(健康组)与42例高间接胆红素血症患儿(观察组)治疗前后血清总胆红素(TBIL)、直接胆红素(DBIL)及磷酸肌酸激酶同工酶(CK-MB)、肌红蛋白MYO、肌钙蛋白(CTNI)、乳酸脱氢酶(LDH)活性,比较3组数据之间的差异。结果观察组与健康组比较,CK-MB、CTNI活性明显升高,差异有显著性(P<0.05);对比观察组治疗前与治疗后,治疗后胆红素及心肌损伤各指标显著降低(P<0.05)。结论高间接胆红素血症的确有一定的心肌损伤,提示临床医生这种心肌损伤是可逆的,对于间接胆红素过高的患儿有必要进行心肌损伤标志物监控,注意对心肌的保护与治疗,预防心肌损伤。

Objective To observe the changes of myocardial damage markers in neonates with indirect hyperbilirubinemia pre arid post treatment to explore whether there could be myocardial injury in such neonates. Methods Serum levels of total bilirubin （TB） ,direct bilirubin（DB）, creatine kinasd-isoenzyme-MB（CK-MB）, myoglobin（ MYO）, cardiac troponin I（CTNI） and lactate de- hydrogenase（LDH） were detected in 30 cases of healthy neonates without jaundice （healthy group） and 42 cases of neonates with indirect hyperbilirubinemia（observation group） pre and post treatment, and the difference of the results in the three detection groups were analyzed. Results Compared with healthy group,the activity of CK-MB and CTNI significantly enhanced in observa tion group（P〈0.05）. Compared with pre treatment group,the serum level of bilirubin and myocardial enzyme decreased signifi cantly in post treatment group（P〈0.05）. Conclusion There could be reversible myocardial injury in neonates with hyperbilirubi- nemia,indicating the necessity of the detection of myocardial damage markers and the protection and treatment measures for the prevention of myocardial injury.