302例新生儿高胆红素血症心肌酶谱分析

Analysis on myocardial enzymes spectrum in 302 neonates with hyperbilirubinemia

目的探讨新生儿高胆红素血症(简称"高胆")对心肌酶谱的影响。方法以302例高胆新生儿为研究对象,按血清总胆红素(TSB)水平分为轻度和重度高胆组,以同期无黄疸的上呼吸道感染新生儿39例为对照组。应用日立7170A型全自动生化分析仪测定所有患者的心肌酶谱(AST、CK、CK-MB)并比较。结果高胆新生儿血CK、CK-MB与TSB呈正相关,r值分别为0.294、0.205,P值分别为0.000、0.003,AST与TSB无相关性(P>0.05)。重度组CK高于轻度组(t=2.448,P=0.015)和对照组(t=2.512,P=0.014)。轻度和重度高胆组与对照组间的AST、CK-MB两两比较,P值均>0.05,差异无统计学意义。心肌损害总发生率为54.97%;轻度高胆组为52.67%,重度高胆组为70.0%,二者比较差异有统计学意义(χ2=4.209,P<0.05)。结论新生儿高胆红素血症可致心肌损害,高胆红素血症新生儿应常规测定心肌酶谱以指导临床治疗。

[Abstract] Objective To investigate the influence of hyperbilirubinemia on myocardial enzymes spectrum in neonates. Methods Three hundred and two neonates with hyperbilirubinemia were selected and divided into the light-degree group and the severe-degree group by the level of total serum bilirubin （TSB）. Thirty-nine anicteric neo- nates with upper respiratory infection were enrolled as the control group. The myocardial enzymes spectrum （AST,CK, and CK-MB） of all the neonates was tested by Rili 7170A automatic biochemical analyzer. Results The CK and CK-MB in the blood of neonates with hyperbilirubinemia had a positive correlation with the TSB. The r value was 0.294 and 0.205, respectively, and the P value was 0.000 and 0.003, respectively. No correlation was found between AST and TSB （P〉0.05）. CK of the severe-degree group was higher than in the light-degree group （t=2.448, P=0.015） and the control group （t=2.512, P=0.014）. There was no statistically significant difference in AST and CK-MB be- tween the three groups （P〉0.05）. The total incidence of myocardial injury was 54.97%. The incidence was 52.67% in the light-degree group and 70.0% in the severe-degree group, showing statistically significant difference between the two groups （x2=4.209, P〈0.05）. Conclusion The hyperbilirubinemia in neonetes may cause myocardial injury. The myocardial enzymes spectrum of neonates with hyperbilirubinemia should be tested routinely to provide guidance for clinical treatment.