新生儿高胆红素血症心肌酶活性及C-反应蛋白变化的临床分析

目的 通过检测高胆红素血症新生儿心肌酶活性、C-反应蛋白（CRP）水平变化,分析高胆红素血症与心肌细胞活性、CRP之间的关系,为更全面地认识新生儿高胆红素血症提供一定的理论依据.方法 选取高胆红素血症患儿89例,据血清胆红素值分为轻度、重度两组,采用全自动血生化分析仪及免疫比浊法分别于治疗前及治疗后第3天测定血清心肌酶活性及CRP水平,并与无高胆红素血症的新生儿做对照研究.结果 重度高胆红素血症组与对照组相比,所有心肌酶指标活性均显著性增高,轻度组激酸肌酶（CK）、天门冬氨酸氨基转移酶（AST）、激酸肌酶同工酶（CK-MB）等部分指标活性明显升高,CRP水平各组间比较差异无统计学意义.治疗3 d后,黄疸明显减退,复测心肌酶活性基本恢复至正常水平.结论 高胆红素血症患儿心肌酶活性显著性增高,随黄疸加重,心肌酶活性相应增高.高胆红素血症患儿CRP水平未见显著性变化.

The changes of myocardical enzymes activity and the CRP level in neonates with hyperbilirubinemia

Objective To detect the changes of myocardical enzymes activity and CRP level in neonates with hyperbilirubi- nemia, and analyze the correlation between the hyperbilirubinemia and myocardical damage. Methods All the newborns with hyperbilirubinemia were divided into two groups according the serum bilirubin level. Detect the activity of serum myocardical enzyme and CRP at the first day pretherapy and the third day post - treatment, compared with the neonates with hyperbilirubinemia. Results All the indexes of myocardial enzyme activity in severe hyperbilirubinemia group had the statistically changes, parts of the indexes（ CK, AST, CK- MB） had the significant difference in the slight jaundice group. Through therapy, the activity of serum myocaridical enzyme recover to the normal level in three days. The CRP level in hyperbilirubinemia group had no significant change compared with the normal group. Conclusions The detection of myocardical enzyme is helpful to evaluate the patient＇s condition and find out the pathophysiologic mechanisms, CK - MB is the most sensitive index to judge the damage of myocardial cell. The degree of CRP in neonates with hyperbilirubinemia have no statistically difference compared with normal group.