缺血修饰白蛋白在新生儿窒息合并心肌损伤早期诊断价值的临床研究

Ischemia Modified Albumin in Neonatal Suffocation Merger Myocardial Injury Early Diagnosis Value Clinical Research

目的:观察缺血修饰白蛋白(ischem ia modified a lbum in,IMA)在新生儿窒息患者中的变化,探讨其对新生儿窒息合并心肌损伤的早期诊断价值。方法:对97例新生儿窒息患者(心肌损伤44例,非心肌损伤53例;轻度窒息58例,重度窒息39例)及健康对照组51例分别于出生后3h、6h采血,检测IMA实验ACB值(白蛋白钴结合力,ACB),同时检测肌钙蛋白Ⅰ(cTnⅠ)、肌酸激酶同工酶(CK-MB),比较各组ACB值与cTnⅠ、CK-MB的变化。结果:新生儿窒息患者中,心肌损伤组3h、6h的ACB值均显著低于对照组、非心肌损伤组(P<0.01),心肌损伤组6h与3h的ACB值比较差异无统计学意义(P>0.05);重度窒息组3h、6h的ACB值均显著低于轻度窒息组、对照组(P<0.01),重度窒息组6h与3h的ACB值比较差异无统计学意义(P>0.05)。结论:在新生儿窒息合并心肌损伤的诊断中,IMA优于cTnⅠ、CK-MB,具有敏感性更高、出现时间更早的优势,IMA的检测有助于新生儿窒息合并心肌损伤的早期诊断及对窒息程度的鉴别,使患儿得到及时干预治疗,改善预后。

@@@@Objective:To observe the changes of ischemia modified albumin(ischemia modified albumin,IMA)in neonatal suffocation patients, to discuss ischemia modified albumin to the newborn suffocation merger myocardial injury early diagnosis value. Method:97 cases of neonatal suffocation patients and healthy controls were drew blood after the birth of 3,6 h,were tested the IMA ACB value(albumin cobalt binding force,ACB),detection troponinⅠ(cTnⅠ),creatine kinase isoenzyme(CK-MB). To compare the change of two groups ACB value,cTnⅠ,CK-MB. Result:ACB value after the birth of 3,6 h of Myocardial injury group were significantly lower than those of the control group,the myocardial injury group(P<0.01). Myocardial injury group 6 h and 3 h ACB value had no significant difference(P>0.05). ACB value after the birth of 3,6 h in Severe suffocation group were significantly lower than that in mild choking group,the control group(P<0.01). Severe suffocation group 6 h and 3 h ACB value had no significant difference(P>0.05).Conclusion:In neonatal suffocation merger myocardial injury of diagnosis,IMA is better than that of cTn Ⅰ,CK-MB,has higher sensitivity,in earlier time. IMA testing helps sleepy baby merger myocardial injury early diagnosis and the suffocation degree of identification,receives timely intervention treatment in neonatal suffocation merger myocardial injury,improves the prognosis.