新生儿缺氧缺血性脑病心肌酶谱改变及其临床意义的探讨

Changes of myocardial enzymes spectrum in neonates with hypoxic ischemic encephalopathy and its clinical significance

目的观察新生儿缺氧缺血性脑病心肌酶谱的改变情况并且讨论其临床意义。方法选取2015年1月至2016年1月在本院接受治疗的缺氧缺血性脑病新生儿60例作为病例组,选取同时期在本院出生的健康新生儿50例作为对照组。根据病例组中患儿的严重程度,将病例组患儿分为重度(n=10)、中度(n=31)和轻度(n=19)。取新生儿清晨静脉血,采用全自动生化分析仪检测心肌酶谱指标(谷草转氨酶AST、肌酸激酶CK、乳酸脱氢酶LDH、α-羟丁酸酶α-HBDH、肌酸激酶同工酶CK-MB)。比较病例组和对照组心肌酶谱各指标水平,比较病例组中不同严重程度缺氧缺血性脑病新生儿心肌酶谱各指标水平,比较病例组患儿治疗前和治疗后心肌酶谱各指标水平。结果病例组新生儿和对照组新生儿心肌酶谱各检测指标差异具有统计学意义(P<0.05),病例组中,重度组患儿心肌酶谱各指标显著高于中度组和轻度组(P<0.05),中度组患儿心肌酶谱各指标显著高于轻度组(P<0.05),病例组患儿治疗后心肌酶谱各指标水平显著低于治疗前(P<0.05)。结论新生儿缺氧缺血性脑病容易并发心肌的损伤,并且随着患儿病情严重程度的增加心肌的损伤程度亦增加。

Objective To observe changes of myocardial enzymes spectrum in neonates with hypoxic ischemic encephalopathy and discuss its clinical significance. Methods Choose with hypoxic ischemia encephalopathy treated our hospital from January 2015 and January 2016 （60 cases as a group, selected50 cases of healthy newborns as control group. According to the severity of the children and, neonatal patients were divided into severe （n= 10）, medium （n= 31） and mild （n= 19）. Took venous blood in the morning, every newborn using automatic biochemical analyzer to detect myocardial enzyme spectrum index （including： aspertate aminotransferase AST, creatine kinase （ CK, LDH, alpha hydroxybutyric acid lactic dehydrogenase enzymes alpha HBDH）, compared the case group and the control group the index level of myocardial enzyme spectrum comparison cases of different severity of neonatal hypoxic ischemic encephalopathy （ the index level of myocardial enzyme spectrum comparison cases before and after treatment in patients with myocardial enzyme. Results There were significant differences in the detection of myocardial enzymes in neonates and controls （P〈0. 05）; In the case group, the indexes of myocardial enzymes in the severe group were significantly higher than those in the moderate group and the mild group （ P 〈 0. 05 ） ; The indexes of myocardial enzymes in moderate group were significantly higher than those in mild group （P〈0.05） ; The levels of myocardial enzymes in the treatment group were significantly lower than those before treatment （ P 〈 0. 05 ）. Conclusions Neonatal hypoxic ischemic encephalopathy can cause myocardial injury simultaneously, and as the severity of the disease increased, the degree of myocardial damage increased.