新生儿缺氧缺血性脑病血清CK—MB、cTnI和血浆BNP检测结果分析

Analysis of serum CK-MB, cTnI and plasma BNP levels in neonatal hypoxic ischemic encephalop- athy

目的探讨肌酸激酶同工酶MB（CK-MB）、心肌肌钙蛋白I（cTnI）和脑钠肽（BNP）对评估新生儿缺氧缺血性脑病（HIE）合并心肌损伤的价值。方法实验组为76例足月HIE新生儿，按临床分度标准分为轻度HIE组35例、中度HIE组27例和重度HIE组14例，对照组20例。用ELISA方法检测实验组及对照组血清CK-MB、cTnI及血浆BNP水平，HIE组治疗前后分别与对照组进行比较；HIE组治疗前后进行比较。结果①治疗前轻、中、重度HIE组CK—MB、cTnI及BNP水平均较对照组升高，差异有统计学意义（P〈0．01），且HIE程度越重，CK-MB、cTnI及BNP水平越高（P〈0．01）；②治疗后轻、中、重度HIE组CK．MB、cTnI及BNP水平均较治疗前下降。差异有统计学意义（P〈0．01）。③治疗后轻、中、重度HIE组间CK—MB水平差异无统计学意义（P〉0．05）；中、重度HIE组cTnI和BNP水平仍较轻度HIE组升高，差异有统计学意义（P〈0．01）。结论检测CK-MB、cTnI及BNP可早期、全面评估新生儿HIE合并心肌损伤程度及心功能，动态监测cTnI及BNP可评估疗效及预后。

Objective To study the clinical value of combined detection of CK-MB, cTnI and BNP on neonatal hypoxic ischemic encephalopathy with myocardial injury. Methods Seventy-six full- term HIE newboms were divided into three groups： 35 mild HIE newborn babies, 27 moderate HIE new- born babies and 14 severe HIE newborn babies. The serum CK-MB, cTnI and plasma BNP concentra- tions were obtained using enzyme immunoassay before and after treatment respectively. Twenty normal subjects were studied as controls. Results ① Compared with control values, CK-MB, cTnI and BNP concentrations were significantly elevated in HIE newboms（P 〈 0. 01 ）. The value of them increased with severity increased（P 〈 0. 01 ）. ② After treatment, CK-MB, cTnI and BNP decreased remarkable（P 〈 0. 01 ）. ③There were no significant differences in CK-MB levels after treatment among the three HIE groups in convalescence （ P 〉 0. 05 ）. The value of cTnI and BNP raised remarkly even after. treatment in moderate and severe groups （P 〈0. 01 ）. Conclusions Combined detection of CK-MB, ischemic cTnI encep and prognosis and BNP should be useful and sensitive in early and overall assessment of neonatal hypoxic halopathy with myocardial injury, dynamic monitor of cTnI and BNP can evaluate effect and prognosis.