新生儿窒息与血乳酸和心肌酶水平的关系

Relationship of neonatal asphyxia with serum lactic acid and myocardial enzymes

目的探讨新生儿窒息与血乳酸和心肌酶水平的关系。方法选择2015年1月-2016年12月期间湛江中心人民医院儿科收治的新生儿窒息患儿50例纳入观察组,同期未合并窒息的足月新生儿50例作为对照组,比较两组新生儿动脉血乳酸、pH值、剩余碱(BE)以及血清肌酸激酶(CK)、肌酸激酶同工酶(CKMB)、心肌肌钙蛋白T(cTnT)等指标的水平。结果观察组动脉血乳酸水平为(4.92±1.68)mmol/L,明显高于对照组的(1.31±0.47)mmol/L,pH值及BE分别为(7.18±0.15)、(-6.12±2.34)mmol/L,明显低于对照组的(7.32±0.24)、(-3.81±1.43)mmol/L,差异均有统计学意义(P<0.05);观察组血清CK、CK-MB及cTnT分别为(587.24±153.63)U/L、(68.97±17.28)U/L、(128.97±39.62)pg/mL,明显高于对照组的(203.71±48.36)U/L、(22.53±5.46)U/L、(29.54±5.88)pg/mL,差异有统计学意义(P<0.05)。结论新生儿窒息可引起心肌损伤,血乳酸和心肌酶测定有利于心肌损伤的早期诊断。

Objective To study the relationship between neonatal asphyxia and serum lactic acid,myocardial enzyme levels.Methods Fifty patients of neonatal asphyxia treated in Neonatal Department in Central People＇s Hospital of Zhanjiang from January 2015 to December 2016 were included into the observation group,and 50 full-term newborn infants in the same period without asphyxia were enrolled as the control group.The neonatal arterial blood lactic acid,pH,base excess（BE） index,and serum creatine kinase（CK）,creatine kinase isozyme（CKMB） and cardiac troponin T（cTnT） levels were compared between the two groups.Results In the observation group,arterial blood lactate,pH,BE were（4.92±1.68） mmol/L,（7.18±0.15）,（-6.12±2.34） mmol/L,respectively,as compared with（1.31±0.47） mmol/L,（7.32±0.24） mmol/L,（-3.81±1.43） in the control group（P0.05）.The serum levels of CK,CK-MB and cTnT respectively were（587.24±153.63） U/L,（68.97±17.28） U/L,（128.97±39.62） pg/mL,significantly higher than（203.71±48.36） U/L,（22.53±5.46） U/L,（29.54±5.88） pg/mL in the control group（P0.05）.Conclusion Neonatal asphyxia can cause myocardial damage,and the determination of lactic acid and myocardial enzymes is helpful to the early diagnosis of myocardial injury.