心肌酶谱和血清肌钙蛋白测定在新生儿缺氧性肺动脉高压诊断中的应用

The Application of Myocardial Enzyme Spectrum and Serum Cardiac Troponin in Neonates with Hypoxic Pulmonary Hypertension

目的:探讨心肌酶谱和血清肌钙蛋白测定在新生儿缺氧性肺动脉高压(HPH)中的诊断价值。方法:HPH患儿作为实验组,并与同期入院的非缺氧和心肌损害患儿作为对照组,每组各30例,分别于出生后第1d和第7d检测两组患儿心肌酶谱和血清肌钙蛋白(cTnI),自动血气分析仪测定氧分压(PaO2),三尖辨返流压差法测定肺动脉收缩压(PASP),比较两组患儿心肌酶谱、cTnI与PaO2及PASP之间的关系。结果:第1d时实验组LDH、CK、CK-MB、a-HBDH、cTnI均显著高于对照组(P<0.01);出生后第1d实验组PASP显著低于对照组,PaO2显著高于对照组(P<0.01),第1d时实验组PaO与CK-MB、cTnI呈明显负相关(P<0.05)。结论:CK-MB和cTnI与PASP呈明显正相关,与PaO2呈明显负相关,可作为早期诊断HPH的特异性指标之一。

Objective： To explore the clinical value of myocardial enzyme spectrum and serum cardiac troponin in neonates with hypoxic pulmonary hypertension （HPH） . Methods： HPH neonates was the experimental group and the children with non -hypoxia and myocardial damage was the control group in the same period. For 30 eases in each group, tests were carried out separately on the 1st and 7th day after birth, which contain the level of myocardial enzyme spectrum and cTnI, the partial pressure of oxygen （PaO2 ） by automatic blood analyzer, pulmonary artery systolic pressure （PASP） by the method of three sharp resolution of reflux pressure difference. The relationship between myocardial enzyme spectrum and cTn! and PaO2 and PASP were compared. Results： On the 1 st day, the LDH, CK, CK - MB, a - HBDH and cTnI in experimental group were significantly higher than those in control group （ P 〈 0.01 ） . The PASP of experimental group was significantly lower than that of control group, but PaO2 was significantly higher than that of control group （ P 〈 0. 01 ） . The PaO and CK - MB, cTnI in experimental group were negatively related （ P 〈 0. 05 ） . Conclu- sions： The CK - MB and cTnI were positively correlated with PASP, and was negatively with PaO2, which will be regarded as one of the indexes testing the features of HPH in the early period.