新生儿缺氧缺血性脑病血清超敏C反应蛋白和心肌酶谱的变化及意义

目的探讨超敏C反应蛋白（hs-CPR）、心肌酶谱在新生儿缺氧缺血性脑病（HIE）中的变化及其意义。方法采用全自动生化分析仪测定91例HIE患儿生后第1、第7天,以及33例正常新生儿（对照组）血清hs-CPR和心肌酶谱水平。结果HIE患儿生后第1天血清hs-CPR及CK、CK-MB、AST、LDH水平均较对照组明显增高（p〈0.01）。HIE患儿重度组血清hs-CPR较轻度组明显升高（p〈0.05）,但轻度与中度组、中度与重度组hs-CPR比较差异无统计学意义（p〉0.05）。HIE患儿病情越重,心肌酶升高越明显。HIE患儿治疗后血清hs-CPR及CK、CK-MB、AST、LDH水平均较治疗前明显降低（p〈0.01）,但血清心肌酶学各项指标与对照组比较,差异仍有统计学意义（p〈0.01）,而治疗后血清hs-CPR水平与对照组比较,差异无统计学意义（p〉0.05）。结论动态观察hs-CPR和心肌酶谱的变化,对HIE的早期诊断、指导治疗及预后判断有重要意义。

Alteration and clinical significance of serum hs-CRP and myocardial enzymes in newborns with hypoxic-ischemic encephalopathy

Objective To investigate the changes of high-sensitivity C reactive protein （hs-CRP） and myocardial enzymes levels in newborns with hypoxic-ischemic encephalopathy （HIE） and those clinical significance. Methods Serum hs-CRP and myocardial enzymes levels in 91 infants with HIE at the first,seventh day of birth as well as 33 healthy newborns （the controls） were measured by automatic biochemistry analyzer. Results The serum hs-CRP and CK,CK-MB,AST,LDH levels in newborns with HIE in the first day of birth were significantly higher than those of the controls （p〈 0.01）. The hs-CRP level in severe group of HIE was significantly higher than that of slight group （p 〈0.01）,but there was no significant difference between slight and moderate group,moderate and severe group （p 〉0.05）. The more severe the condition,the higher the levels of myocardial enzyme in HIE newborns. Compared with before treatment,the serum hs-CRP and CK,CK-MB,AST,LDH levels in HIE newborns were significantly decreased after treatment （p〈 0.01）,but serum indexes of myocardial enzyme still higher than the controls （p 〈0.01）,while the serum hs-CRP level had no significant difference between HIE newborns and the controls （p〉 0.05）. Conclusion The variation of hs-CRP and myocardial enzymes levels in newborns with HIE can be used as the vital indexes for early diagnosis,directing treatment and judging prognosis of HIE.