血清肌酸激酶同工酶和心肌肌钙蛋白T在新生儿窒息程度及临床疗效评价中的作用

The Role of Serum CK-MB and cTnT in Neonatal Asphyxia Degree and Clinical Curative Effect Evaluation

目的:评价肌酸激酶同工酶(CK-MB)与肌钙蛋白T(cTnT)在新生儿窒息时心肌损害临床诊断中的价值。方法:根据新生儿窒息及严重程度诊断标准纳入符合条件的80例新生儿窒息患儿,分为轻度组和重度组各40例,并纳入健康新生儿40例作为对照组。在出生时以及治疗7 d后采集窒息患儿和健康新生儿的血液,分别应用免疫抑制法和电化学发光法测定CK-MB和cTnT的含量。结果:随着患儿窒息程度加重,CK-MB、cTnT水平升高(P<0.05),轻度组、重度组与对照组CK-MB、cTnT值比较差异有统计学意义(P<0.05),重度组较轻度组CK-MB、cTnT亦有明显升高且差异有统计学意义(P<0.05)。治疗后轻度组、重度组CK-MB、cTnT均较治疗前明显下降,与治疗前比较差异有统计学意义(P<0.05);治疗后轻度组、重度组CK-MB、cTnT水平与对照组比较差异无统计学意义(P>0.05)。结论:新生儿CK-MB、cTnT水平随着窒息程度加重而升高,经有效治疗后,患儿血清中CK-MB、cTnT水平均可恢复正常水平。血清中CK-MB、cTnT可以作为评价新生儿窒息严重程度的指标,可灵敏、准确地发现窒息新生儿患儿,并可对窒息新生儿治疗后的疗效进行评价。

Objective： To estimate the value of CK-MB and cTnT in diagnose the myocardial damage due to asphyxia of neonates. Methods： According to diagnostic criteria of neonatal asphyxia and severity eighty cases of neonatal asphyxia were divided into mild group （40 cases） and severe group （40 cases）. And healty neonates （40 cases） were also included as control group. The serums from all of the neonates were got at birth and after 7 days＇ treatment. Immunosuppressional and electrochemical luminescence methods were used to determine the values of CK-MB and cTnT respectively. Results： The levels of CK-MB and cTnT increase with the increase as the severity of asphyxia. Compared with control group, the levels of CK-MB and cTnT in mild and severe group were significantly higher and the differences were statistically significant （P〈0.05）. Compared with the mild group, the levels of CK-MB and cTnT in severe group also significantly increased and the differences were statistically significant （P〈O. 05）. After treatment, the levels of CK-MB, cTnT in mild and severe group had no statistically significant difference with control group （P〉O. 05 ）. Conclusion： The levels of CK-MB and cTnT increased with the increase as the severity of asphyxia in neonates. After treatment, the value of CK-MB and eTnT of neonatal asphyxia return to normal. The CK-MB and cTnT of serum have high specificity to evaluate the severity of asphyxiated neonates, so they can better assist pediatricians in clinically diagnosing whether there is asphyxiated neonates or not, and evaluate the effect after tharapy.