心肌酶谱与脐动脉血气分析在新生儿窒息中的诊断效果观察

目的探讨心肌酶谱与脐动脉血气在新生儿窒息（HIE）中的临床应用价值。方法选取本院收治的92例HIE为研究对象,根据患儿Apgar评分将其分为轻度HIE组（32例）、中度HIE组（33例）以及重度HIE组（27例）,并选取同期在本院出生的100例足月健康新生儿为对照组,分别测定各组心肌酶谱（CK、AST、CK﹣MB、LDH、HB-DH）、神经特异性烯醇化酶（NSE）以及脐动脉血气（pH、PaO2、PaCO2、BE）。结果①HIE组患儿心肌酶谱、NSE水平显著高于对照组,而脐动脉血气pH值水平显著低于对照组,差异显著（P〈0.05）;HIE组患儿心肌酶谱、神经元特异性烯醇化酶（NSE）水平随着病情的加重而显著上升,而脐动脉血气中的Ph值水平随着患儿病情的增加而下降。②HIE组血清中心肌酶谱与NSE呈正相关（P〈0.05）,而脐动脉血气pH值与HIE脏器损伤呈负相关（P〈0.05）。③HIE预后效果理想的患儿心肌酶谱、NSE水平低于预后效果差者,而脐动脉血气pH值则高于预后效果差者,差异有统计学意义（P〈0.05）。结论心肌酶谱与脐动脉血气pH值可作为HIE病情早期诊断的指标,同时可作为患儿预后的早期标志物。

Effect of myocardial enzymes and umbilical arterial blood gas analysis in the diagnosis of neonatal asphyxia

Objective To investigate the myocardial enzymes and umbilical arterial blood gas in the clinical value of neonatal asphyxia（HIE）.Methods 92cases of HIE were selected in our hospita for the study,children with Apgar scores were divided into mild HIE group（32cases）,moderate HIE group（33cases）,and severe HIE group（27cases）,and 100cases of full-term healthy newborns born were selected in the hospital for the control group.The myocardial enzymes（CK,AST,CK-MB,LDH,HBDH）,neuron-specific enolase（NSE）and umbilical arterial blood gas（pH,PaO2,PaCO2,BE）of all neonatal asphyxias were measured.Results ①children with HIE group,myocardial enzymes,NSE level was significantly higher umbilical arterial blood gas pH level was significantly lower than the control group,the difference was significant（P0.05）;HIE group of children myocardial enzymes,NSE levels increased significantly as the disease worsens,the level of umbilical arterial blood gas pH value decreases with the increase of children with the disease.②HIE serum myocardial enzymes and NSE was a positive correlation（P0.05）,and umbilical arterial blood gas pH and HIE organ damage was negatively correlated（P0.05）.③the HIE prognosis is favorable and the children myocardial enzymes,NSE levels lower than the prognosis poor,and umbilical arterial blood gas pH value was higher than the poor prognosis,the difference was statistically significant（P0.05）.Conclusion myocardial enzymes and umbilical arterial blood gas pH value can be used as HIE indicators of the disease early diagnosis,at the same time can be used as an early marker of prognosis in children.