新生儿窒息心肌酶谱水平变化的临床研究

Clinical analysis of myocardial enzyme levels in neonates with asphyxia

目的分析窒息新生儿心肌酶谱水平的变化情况,探讨其临床意义。方法选取2012年3月—2013年12月收治的88例窒息新生儿为研究对象,其中轻度窒息新生儿48例(轻度组),重度窒息新生儿40例(重度组),以同期住院治疗的42例无窒息新生儿作为对照组,采用全自动生化分析仪对各组新生儿的血清心肌酶谱水平进行检测并辅以心电图检查。比较治疗前后3组患儿心肌酶谱水平的变化情况。结果治疗前,轻度组新生儿的谷草转氨酶(AST)、乳酸脱氢酶(LDH)、α-羟丁酸脱氢酶(α-HBDH)、肌酸激酶(CK)和肌酸激酶同工酶(CK-MB)等指标均明显高于对照组患儿,而重度组上述指标均明显高于轻度组,比较差异均具有统计学意义(P<0.05);经治疗1周后,所有窒息新生儿的心肌酶谱水平均明显低于治疗前,其中轻度组患儿的心肌酶水平均恢复正常,重度组患儿仍高于正常水平,轻度组患儿的心肌酶谱水平明显低于重度组,比较差异均具有统计学意义(P<0.05)。结论采用全自动生化分析仪检测窒息新生儿的心肌酶谱水平可及时了解患儿的心肌受损情况,对此类新生儿的临床诊断和治疗具有积极意义。

Objective To analyze the changes in myocardial enzyme levels in neonates with asphyxia, and to explore its clinical significance. Methods A hospital in March 2012 - December 2013 were treated 88 cases of neonatal asphyxia for the study, 48 cases of neonatal asphyxia mild （mild group）, 40 cases of severe neonatal asphyxia （severe group）, In the same period 42 cases of hospitalized newborns without asphyxia as a control group, using automatic biochemical analyzer neonatal serum myocardial enzyme levels were detected in each group supplemented ECG. Three groups of children before and after the changes in myocardial enzyme levels compare treatment. Results Before treatment, the mild group of newborns aspartate aminotransferase （AST）, lactate dehydrogenase （LDH）, α- hydroxybutyrate dehydrogenase （α- HBDH）, creatine kinase （CK） and creatine kinase Workers enzyme （CK- MB） and other indicators were significantly higher in children, and severe group were significantly higher than these indicators mild group, the difference was statistically significant （P 〈 0. 05 ） ; 1 week after treatment, All newborn asphyxia water myocardial enzymes were significantly lower than before treatment, in which the group of children with mild cardiac enzyme levels were back to normal, children with severe group still higher than normal levels of myocardial enzyme levels in children with mild group significantly lower than the severe group, the difference was statistically significant （ P 〈 0.05 ）. Conclusion The use of automatic biochemical analyzer neonatal asphyxia myocardial enzyme levels in children can keep abreast of myocardial damage, with positive implications for clinical diagnosis and treatment of these newborns.