高未结合胆红素血症新生儿心肌酶活性的临床研究

Clinical study of myocardial enzyme activity in neonates with unconjugated hyperbilirubinemia

目的探讨心肌酶活性检测对高未结合胆红素血症新生儿的临床意义。方法 120例高未结合胆红素血症患儿作为研究组,给予对症治疗,治疗前后对所有患儿进行心肌酶活性、血清间接胆红素(IBIL)水平测定;同期120例健康新生儿作为对照组,进行心肌酶谱相关指标[肌酸激酶同工酶(CK-MB)、乳酸脱氢酶(LDH)、谷草转氨酶(AST)、肌酸激酶(CK)]检测。结果研究组心肌酶谱各项指标(CK-MB、LDH、CK、AST)水平均高于对照组,差异具有统计学意义(t=14.2789、15.6393、11.6074、12.1411,P<0.05)。经过对症治疗后,研究组患儿CK-MB、LDH、CK、AST、IBIL水平分别为(17.4±14.2)U/L、(423.1±197.2)U/L、(123.1±110.7)U/L、(35.3±19.5)U/L、(47.5±44.7)μmol/L,均较治疗前的(43.2±18.7)U/L、(1211.1±541.6)U/L、(315.3±190.3)U/L、(71.3±30.4)U/L、(289.6±82.4)μmol/L明显降低,差异具有统计学意义(t=12.0366、14.9763、9.5634、10.9191、28.2907,P<0.05)。结论高未结合胆红素血症患儿有明显的心肌受损情况,心肌酶水平会明显升高,且黄疸越严重,患儿的心肌酶水平越高。

Objective To explore the clinical significance of detection of myocardial enzyme activity in neonates with unconjugated hyperbilirubinemia. Methods A total of 120 neonates with unconjugated hyperbilirubinemia as research group received symptomatic treatment, and the activities of myocardial enzymes and serum indirect bilirubin （IBIL） levels were measured before and after treatment. Concurrent 120 health neonates as control group received detection of myocardial enzymes related indexes [ creatine kinase isoenzyme （CK-MB）, lactate dehydrogenase （LDH） and aspartate aminotransferase （AST）, creatine kinase （CK） ]. Results The research group had higher myocardial enzymes related indexes （CK-MB, LDH, CK and AST） levels than the control group, and their difference had statistical significance （t=14.2789, 15.6393, 11.6074, 12.1411, P〈0.05）. After symptomatic treatment, the research group had CK-MB, LDH, CK, AST and IBIL levels respectively as （17.4± 14.2） U/L, （423.1 ± 197.2） U/L, （123.1 ± 110.7） U/L, （35.3 ±19.5） U/L and （47.5 ±44.7） μmol/L, which were all lower than （43.2 ± 18.7） U/L, （1211.1 ± 541.6） U/L, （315.3 ± 190.3） U/L, （71.3 ± 30.4） U/L, （289.6± 82.4） μmol/L before treatment, and their difference had statistical significance （t=12.0366, 14.9763, 9.5634, 10.9191, 28.2907, P〈0.05）. Conclusion There was obvious myocardial damage in children with unconjugated hyperbilirubinemia, and their level of myocardial enzymes increases obviously. The more severe the jaundice is, the higher the myocardial enzyme level is.