血浆心肌营养因子-1在新生儿缺氧缺血性脑病合并心肌损伤中的变化及临床意义

Changes and clinical significance of blood plasma cardiotrophin-1 in hypoxic ischemic encephalopathy neonates with myocardium injury

目的观察血浆心肌营养因子-1(CT-1)在新生儿缺氧缺血性脑病(hypoxic ischemic encephalopathy,HIE)合并心肌损伤中的变化及临床意义。方法将本院收治的HIE患儿50例按HIE病情程度分为轻度组和中/重度组,选取同期于本院出生的正常足月健康新生儿50例为对照组,检测并比较三组研究对象血浆CT-1、血清肌酸激酶同工酶(CK-MB)和心肌肌钙蛋白I(CTn I)水平;比较轻度组和中/重度组患儿急性期和恢复期血浆CT-1水平,并分析HIE患儿血浆CT-1与血清CK-MB和CTn I的相关性。结果中/重度组患儿CT-1、CK-MB及CTn I水平均高于轻度组和对照组(P<0.05),轻度组患儿CT-1、CK-MB及CTn I水平均高于对照组(P<0.05);HIE合并心肌损伤患儿恢复期血浆CT-1水平均低于急性期(P<0.05),且血浆CT-1水平与血清CK-MB和CTn I水平呈正相关(r=0.564,P=0.000;r=0.624,P=0.000)。结论检测血浆CT-1水平有助于诊断HIE新生儿心肌损伤及判断HIE病情程度。

Objective To observe the changes and clinical effect of blood plasma cardiotrophin-1（CT-1） in hypoxic ischemic encephalopathy（HIE） neonates with myocardium injury.Method 50 neonates with HIE in our hospital according to the degree of HIE were divided into mild group and moderate/severe group,50 cases of normal healthy newborns who were born in our hospital during the same period were selected as control group,plasma CT-1 levels,serum creatinine kinase MB（CK-MB） and cardiac troponin I（CTn I） levels among the three groups were measured and compared;plasma CT-1 levels of mild group and moderate/severe group in acute stage and recovery stage were compared;analyzed the correlation between CT-1 level and serum CK-MB and CTn I levels in neonates with HIE.Result Levels of CTn I,CK-MB and CT-1 in moderate/severe group were higher than mild group and control group（P〈0.05）,CTn I,CK-MB and CT-1 levels of mild group were higher than control group（P〈0.05）,CT-1 levels of HIE neonates with myocardium injury in recovery stage were lower than acute stage（P〈0.05）;levels of plasma CT-1 and serum CK-MB and CTn I were positively related（r = 0.564,P = 0.000;r = 0.624,P = 0.000）.Conclusion Plasma CT-1 levels are conducive to diagnose the myocardium injury in neonates with HIE and determine the degree of HIE disease.