新生儿窒息后心肌肌钙蛋白Ⅰ与心肌酶活性的时相变化及其意义

目的：探讨新生儿窒息后心肌肌钙蛋白Ⅰ(CTnⅠ)及心肌酶活性的时相变化。方法：化学发光法和全自动生化分析仪测定新生儿窒息组26例(轻度窒息16例，重度窒息10例)和对照组10例生后0 h，6 h，12 h，24 h，72 h，10 d血清CTnI水平、肌酸激酶(CK)、肌酸激酶心型同工酶(CK-MB)、乳酸脱氢酶(LDH)及天门冬酸氨基转移酶(AST)活性。结果：窒息组0 h血清CTnI水平，CK，CK-MB和LDH活性明显高于对照组，均P<0.01；其中CTnI峰值在12 h，48 h开始下降；CK活性峰值为6 h，而CK-MB活性于12～24 h达高峰，均于72 h后下降；LDH活性于12 h达高峰，AST活性则于6 h开始升高，24 h后降低。结论：窒息新生儿生后早期动态监测血清CTnI与心肌酶活性有助于及时诊断和治疗心肌损害。

Dynamic Changes in Serum Cardiac Troponin I Levels and Myocardial Enzyme Activities Following Asphyxia in Newborns

Objective To evaluate dynamic changes in serum cardiac troponin I (CTnI) levels and myocardial enzyme activities following asphyxia in newborns. Methods Serum CTnI levels, and creatine dinase (CK), creatine kinase MB isoenzyme (CK MB), lactic dehydrogenase (LDH) and aspartate aminotransferase (AST) activities were measured by the automatic chemoluminescence and biochemical assay at 0, 6, 12, 24, 72 hr and 10 days in 26asphyxiated newborns ( 16 with mild asphyxia and 10 with severe asphyxia) and in 10 non asphyxiated neonates.Results Serum CTnI levels, and CK, CK MB, and LDH activities in both mild and severe asphyxia infants were significantly higher than those in the controls (P< 0.01 ). In the asphyxiated infants, the peak values of CK and AST occurred at 6 hr, of CTnI and LDH at 12 hr, and of CK MB at 12～24 hr of life. The levels declined gradually after treatment. Conclusions Determination of serum levels of CTnI and CK, CK MB, LDH, and AST activities are helpful in making an earlier diagnosis and in planning effective treatment for myocardial damage following asphyxia in newborns.