心肌酶谱对中重度缺氧缺血性脑病新生儿亚低温治疗效果的评估价值

The application value of myocardial zymogram in evaluating the curative effects of mild hypothermia therapy on moderate or severe neonatal HIE

目的探讨心肌酶谱评估对亚低温中重度缺氧缺血性脑病新生儿疗效的价值。方法将2016年1月至2020年1月重症救治中心收治的100例行亚低温治疗的新生儿缺氧缺血性脑病患儿作为观察组,同期选取医院产科出生的52例健康新生儿作为对照组。比较2组研究对象一般资料,收集2组研究对象股静脉血3 ml,采用日本东芝2000型全自动生化仪检测心肌酶谱,分析心肌酶谱对中重度缺氧缺血性脑病新生儿亚低温治疗后的评估价值。结果2组研究对象在性别、出生体质量、分娩方式、胎龄比较,差异无统计学意义(P>0.05);观察组碱剩余、pH值、1 min Apgar评分明显低于对照组,乳酸显著高于对照组,差异有统计学意义(P<0.05)。轻度、中度和重度患儿CK、CK-MB、LDH、HBDH水平比较,差异有统计学意义(P<0.05),且随着病情严重程度增加,CK、CK-MB、LDH、HBDH水平明显增高(P<0.05)。结论缺氧缺血性脑病新生儿心肌酶谱表达水平升高,心肌酶谱可作为缺氧缺血性脑病新生儿实施亚低温治疗预后的评估指标。

Objective To investigate the application value of myocardial zymogram in evaluating the curative effects of mild hypothermia therapy on moderate or severe neonatal hypoxic ischemic encephalopathy(HIE).Methods One hundred neonates with moderate or severe HIE who were treated by mild hypothermia therapy in out hospital from January 2016 to January 2020 were enrolled as observation group,at the same time,the other 52 healthy neonates were enrolled as control group.The general information,and the myocardial zymogram as well as curative effects were observed and compared between the two groups.Results There were no significant differences in gender,birth body mass,delivery mode and gestational age between the two groups(P>0.05).The buffuer excess,pH,1min Apgar scores in observation group were significantly lower than those in control group,however,the lactic acid levels were significantly higher than those in control group(P<0.05).There were significant differences in the levels of CK,CK MB,LDH and HBDH among the mild,moderate and severe cases(P<0.05).Moreover the levels of CK,CK MB,LDH,and HBDH were significantly increased with the aggravation of disease condition(P<0.05).Conclusion The expression levels of myocardial zymogram are increased in the neonates with moderate or severe HIE,and myocardial zymogram can be regarded as the evaluation index in evaluating the prognosis of patients after mild hypothermia therapy.