血清总胆红素动态变化对新生儿心肌酶的影响

Influence of serum total bilirubin in dynamic change on the neonate myocardial enzymes

目的:探讨血清总胆红素动态变化对新生儿心肌酶改变的影响。方法:选择新生儿黄疸患儿227例,参照新生儿高胆红素血症的诊断标准分为生理性黄疸组(生理组)60例,病理性黄疸组(病理组)167例;病理组根据血清总胆红素(TBIL)浓度不同,分为A(TBIL 230～300μmol.L-1)、B(TBIL 301～350μmol.L-1)、C(TBIL>351μmol.L-1)3个亚组,检测各组天门冬氨酸氨基转移酶(AST)、乳酸脱氢酶(LDH)、肌酸激酶(CK)、肌酸激酶同工酶(CK-MB)含量。结果:病理组中B、C亚组AST、CK、CK-MB水平明显高于生理组,差异有统计学意义(P<0.05或P<0.01);B、C亚组AST、CK-MB、LDH水平高于A亚组,差异有统计学意义(P<0.05或P<0.01)。结论:黄疸能引起心肌酶发生改变,高浓度胆红素可致心肌受损。

Objective： To investigate the influence of serum total bilirubin in dynamic change on the neonate myocardial enzymes.Methods： 227 cases of infant patients with icterus neonatorum were chosen,and were divided into two groups referring to diagnostic standard of newborn hyperbilirubinemia： physiologic jaundice group（physiologic group,60 cases） and pathologic jaundice group（pathologic group,167 cases）.Cases in the pathologic group were divided into group A（230~300 μmol·L-1）,B（301~350 μmol·L-1） and C（〉350 μmol·L-1） according to the concentration of serum total bilirubin.Serum AST,LDH,CK,CK-MB in each group were detected.Results： There was a significant difference in comparing the group B,C and physiologic group by AST,CK,CK-MB（P〈0.05 or P〈0.01）.In the pathologic group,AST,CK-MB,LDH in group B and C showed higher than that of group A,there was significantly different（P〈0.05 or P〈0.01）.Conclusion： Icterus could change myocardial enzymes,bilirubin in high concentration might cause cardiac damage.