新生儿脓毒性休克治疗前后血清肌酸激酶同工酶、α-羟丁酸脱氢酶、前白蛋白水平变化及临床意义

Changes of serum levels of creatine kinase isoenzyme,α-hydroxybutyric dehydrogenase,prealbumin after treatment of neonatal septic shock and their clinical significance

目的 探讨新生儿脓毒性休克治疗前后血清肌酸激酶同工酶(CK-MB)、α-羟丁酸脱氢酶(α-HBDH)、前白蛋白(PA)水平的变化及其临床意义。方法 选取120例脓毒性休克新生儿作为病例组,并选择同期于医院分娩的40例正常健康新生儿作为对照组,病例组入院时及治疗2周后监测血清CK-MB、α-HBDH、PA水平,对照组于入院后测定上述指标,分析血清CK-MB、α-HBDH、PA水平变化与脓毒性休克患儿病情变化的关系及其临床意义。结果 病例组入院时血清CK-MB、α-HBDH水平显著高于对照组,PA水平显著低于对照组(P<0.05);轻度脓毒症休克患儿入院时血清CK-MB、α-HBDH水平显著低于重度组,血清PA水平显著高于重度组(P<0.05);病例组治疗2周后CK-MB、α-HBDH显著降低,PA水平显著上升,与入院时比较差异有统计学意义(P<0.05);重度脓毒症休克新生儿CK-MB恢复时间、α-HBDH恢复时间、PA恢复时间及住院时间均显著长于轻度者(P<0.05)。结论 脓毒性休克新生儿伴血清CK-MB、α-HBDH明显上调,PA降低,且随脓毒性休克病情的进展,其血清CK-MB、α-HBDH水平逐渐上升,PA逐渐降低,同时,上述指标的变化与治疗反应存在密切关联。

Objective To explore the changes of serum levels of creatine kinase isoenzyme (CK-MB),α-hydroxybutyrate dehydrogenase (α-HBDH) and prealbumin after treatment of neonatal septic shock and their clinical significance. Methods A total of 120 neonates with septic shock admitted to the hospital were selected as case group, and another 40 normal healthy neonates who were delivered in the hospital during the same period were selected as control group. Serum levels of CK-MB ,α-HBDH and PA before treatment and after 2 weeks of treatment were monitored in case group, and were determined after admission in control group. The relationship between changes of serum levels of CK-MB,α-HBDH, PA and changes of disease in children with septic shock were explored, and their clinical significance were analyzed. Results The serum levels of CK-MB and α-HBDH in case group were significantly higher after admission while the PA level was lower than that in control group ( P <0.05). Serum levels of CK-MB and α-HBDH in children with mild sepsis shock after admission were higher while serum PA level was lower than those with severe sepsis shock ( P <0.05). The levels of CK-MB and α-HBDH were decreased and the level of PA was increased in case group after 2 weeks of treatment, and there was significant difference compared with before treatment ( P <0.05). The CK-MB recovery time,α-HBDH recovery time, PA recovery time and hospital stay in children with severe sepsis shock were longer than those with mild sepsis shock ( P < 0.05). Conclusion The levels of CK-MB and α-HBDH are obviously up-regulated and the PA level is decreased in neonates with septic shock. With the progression of septic shock, serum CK-MB and α-HBDH levels are gradually increased and PA level gradually decreased. The changes of aboveindexes are closely related to the treatment response.