足月儿与早产儿血清CK-MB、MYO、BNP、cTnI水平变化及其临床意义

Changes of serum CK-MB,MYO,BNP and cTnI levels in full-term and premature infants and their clinical significance

目的探讨足月儿与早产儿血清肌酸激酶同工酶（CK-MB）、肌红蛋白（MYO）、脑钠肽（BNP）和肌钙蛋白I（c Tn I）水平的变化及其临床意义。方法选取2012年9月至2015年10月在南京医科大学附属淮安第一医院分娩的新生儿211例,比较足月儿与早产儿的血清CK-MB、MYO、BNP和c Tn I水平的差异;比较足月儿与早产儿的新生儿窒息和新生儿缺血缺氧性脑病发生率的差异;比较新生儿窒息、新生儿缺血缺氧性脑病与正常新生儿的CK-MB、MYO、BNP和c Tn I水平的差异;分析新生儿CKMB、MYO、BNP和c Tn I水平的相关性。结果足月儿血清中的CK-MB和MYO低于早产儿,差异均具有统计学意义（t值分别为7.057、13.029,均P〈0.05）;足月儿与早产儿血清BNP和c Tn I的差异均无统计学意义（均P〉0.05）。足月儿中新生儿窒息和新生儿缺血缺氧性脑病发生率均低于早产儿,且差异均有统计学意义（χ2值分别为13.642、10.913,均P〈0.05）。新生儿窒息、新生儿缺血缺氧性脑病患儿血清中的CK-MB、MYO、BNP和c Tn I水平均高于正常新生儿,且差异具有统计学意义（t=4.088～21.802,均P〈0.05）。新生儿血清中的CK-MB水平与MYO水平呈正相关（r=0.356,P〈0.001）。结论足月儿血清中的CK-MB、MYO低于早产儿,新生儿窒息和新生儿缺血缺氧性脑病患儿血清中的CK-MB、MYO、BNP和c Tn I水平均高于正常新生儿,而且新生儿血清CK-MB与MYO呈正相关。

Objective To investigate the changes of creatine kinase MB（ CK-MB）,myohemoglobin（ MYO）,brain natriuretic peptide（ BNP）,cardiac troponin-I（ c Tn I） levels in full-term and premature infants and their clinical significance. Methods A total of 211 cases of neonates were chosen as research objects. All these infants were delivered at Huai＇an First People＇s Hospital of Nanjing Medical University from September 2012 to October 2015. Comparisons of the differences in serum CK-MB,MYO,BNP,and c Tn I levels,and the incidence rate of neonatal asphyxia and neonatal hypoxic-ischemic encephalopathy（ HIE） were carried out between full-term infants and premature infants. Besides,comparison of the levels of serum CK-MB,MYO,BNP and c Tn I was also conducted among neonates with neonatal asphyxia,neonates with hypoxic ischemic encephalopathy（ HIE） and healthy neonates. Correlations among CK-MB,MYO,BNP and c Tn I levels in neonates were also analyzed. Results Full-term infants had lower levels of CK-MB and MYO in serum than preterm infants,and the differences were statistically significant（ t value was 7. 057 and 13. 029,respectively,both P〈0. 05）. There was no significant difference in serum BNP and c Tn I between full-term and preterm infants（ all P〈0. 05）. The incidence rate of neonatal asphyxia and neonatal HIE were lower in full-term infants than that of the preterm infants. The differences were statistically significant（ χ2value was 13. 642 and 10. 913,respectively,both P〈0. 05）. The levels of CK-MB,MYO,BNP and c Tn I in the serum of neonates with asphyxia or neonatal HIE were higher than those of the healthy neonates. The differences were statistically significant（ t value ranged from4. 088 to 21. 802,all P〈0. 05）. Serum CK-MB level was positively correlated with the level of MYO（ r = 0. 356,P〈0. 001）.Conclusion The levels of CK-MB and MYO in serum of full-term infants are lower than those of the preterm infants. The levels of CK-MB,MYO,BNP and c Tn I in the serum of neonates with asphyxia or HIE are higher than those of the healthy neonates. Serum CK-MB level is positively correlated with the level of MYO in neonates.