体内相关标志物对婴幼儿心肌损害的诊断价值分析

Diagnostic values of relevant markers in vivo for neonatal myocardial damage

目的分析体内相关标志物对婴幼儿心肌损害的诊断价值。方法选取2013年1月至2017年12月河北医科大学第一医院诊治的具有心肌损害高危因素的婴幼儿130例。按照心肌损害发生情况分为心肌损害组(67例)和无心肌损害组(63例)。选取本院同期无高危因素的健康婴幼儿70例为对照组。比较3组入院24 h及48 h血清中糖原磷酸化酶同工酶(GP)BB、心肌肌钙蛋白I(cTnI)、肌酸激酶及肌酸激酶同工酶(CK-MB)水平的变化以及以上指标与心肌损害的关系。结果入院24 h及48 h,心肌损害组患儿血清中GPBB、cTnI、肌酸激酶及CK-MB水平明显高于对照组和无心肌损害组[入院24 h:(21.32±2.78)μg/L比(4.62±0.32)、(4.83±0.12)μg/L,(0.613±0.087)μg/L比(0.036±0.013)、(0.036±0.016)μg/L,(190±5)U/L比(32±5)、(38±6)U/L,(48.9±6.7)U/L比(15.9±4.3)、(18.1±5.2)U/L],差异均有统计学意义(均P<0.05),且入院48 h低于入院24 h。GPBB、cTnI、肌酸激酶及CK-MB与婴幼儿心肌损害呈明显的正相关(r=0.621、0.523、0.502、0.437,P=0.002、0.001、<0.001、0.008)。结论GPBB、cTn I、肌酸激酶及CK-MB与婴幼儿心肌损害呈正相关,可作为临床诊断的参考指标。

Objective To analyze the diagnostic values of relevant markers in vivo for neonatal myocardial damage.Methods A total of 130 infants with high risk of myocardial damage were enrolled from January 2013 to December 2017 in the First Hospital of Hebei Medical University.According to the occurrence of myocardial damage,the infants were divided into myocardial damage group(67 cases)and non-myocardial damage group(63 cases).Seventy healthy infants without high risk factors were enrolled as control group.Levels of serum glycogen phosphorylase isoenzyme(GP)BB,cardiac troponin I(cTnI),creatine kinase(CK)and creatine kinase isoenzyme(CK-MB)were detected at 24 h and 48 h after admission.Relation between these indexes and myocardial damage was analyzed.Results Levels of serum GPBB,cTnI,CK and CK-MB in myocardial damage group were significantly higher than those in control group and non-myocardial damage group at 24 h and 48 h after admission[24 h:(21.32±2.78)μg/L vs(4.62±0.32),(4.83±0.12)μg/L;(0.613±0.087)μg/L vs(0.036±0.013),(0.036±0.016)μg/L;(190±5)U/L vs(32±5),(38±6)U/L;(48.9±6.7)U/L vs(15.9±4.3),(18.1±5.2)U/L](all P<0.05);the levels at 48 h after admission were lower than those at 24 h after admission.GPBB,cTnI,CK and CK-MB were positively correlated with neonatal myocardial damage(r=0.621,0.523,0.502,0.437;P=0.002,0.001,<0.001,0.008).Conclusion GPBB,cTnI,CK and CKMB are positively correlated with neonatal myocardial damage and can be used as reference indexes for clinical diagnosis.