新生儿缺氧缺血性脑病心肌酶谱变化及临床意义

The changes of myocardial enzymogram in neonates with hypoxic-ischemic encephalopathy and its clinical significance

目的 :探讨新生儿缺氧缺血性脑病 (HIE)患儿血清心肌酶谱变化及临床意义。方法 :对 4 2例 HIE患儿与 36例正常新生儿测定其血清中乳酸脱氢酶 (L DH)、α-羟丁酸脱氢酶 (α- HBDH)、肌酸肌酶 (CK)和肌酸肌酶同工酶 (CK- MB)的活性。结果 :HIE患儿心肌酶谱测定值较正常新生儿对照组明显升高 (P<0 .0 1) ,且与不同病情程度呈正相关 ,即病情越重 ,心肌酶谱升高越明显 (P <0 .0 5、P <0 .0 1及 P <0 .0 0 1) ,重度 HIE死亡组心肌酶谱测定值较存活组明显升高 (P <0 .0 1及 P<0 .0 0 1)。结论 :HIE患儿血清心肌酶谱检测对判断病情、估计预后、指导治疗具有重要的临床意义。

Objective:To evaluate the changes in myocardial enzyme in neonates with hypoxic ischemic encephalopathy(HIE) and its clinical implication. Methods: Lactate dehydrogenase(LDH), α-hydroxybutyric dehydrogenase(α-HBDH),creatine kinase(CK), and hybrid muscle CK isozyme(CK-MB) were measured in 42 neonates with HIE and 36 normal neonates. Results: Total activities of serum LDH,α -HBDH,CK and CK-MB in neonates with HIE were significantly higher than those in normal neonates(P<0.01),and the changes in LDH, α-HBDH,CK and CK-MB levels were correlated with the severity of HIE(P<0.05,P<0.01),Myocardial enzymogram in died neonates was significantly higher compared with survived neonates in severe HIE (P<0.01) .Conclusion: Measurement of myocardial enzyme in the patients with HIE measurement is beneficial in judging the condition of illness, evaluating prognosis and guiding therapy.