缺氧缺血性脑病新生儿血清心肌肌钙蛋白I及脑型肌酸激酶同工酶的变化及临床意义

目的探讨新生儿缺氧缺血性脑病(HIE)早期血清脑型肌酸激酶同工酶(CK-BB)及心肌肌钙蛋白I(cTnI)水平的变化及临床意义。方法 106例HIE新生儿(HIE组)于出生后24 h测定血清CK-BB及cTnI水平,并与同期36例健康新生儿(对照组)进行比较。结果中、重度HIE患儿出生后24 h血清CK-BB及cTnI水平高于对照组(P<0.01);轻度HIE患儿血清CK-BB水平高于对照组(P<0.05),但cTnI水平比较差异无统计学意义(P>0.05);轻、中、重度HIE患儿之间CK-BB及cTnI水平比较差异均有统计学意义(P<0.01)。出生7、14 d时,新生儿行为神经(NBNA)评分<35的HIE新生儿血清CK-BB、cTnI水平均高于NBNA评分≥35者(P<0.01)。结论 HIE新生儿出生后24 h检测CK-BB及cTnI水平有助于评估HIE严重程度及患儿预后。

Changes and clinical significance of serum cardiac troponin and creatine kinaes BB isozyme in newborns with hypoxic-ischemic encephalopathy

Objective To study the changes and clinical significance of serum cardiac troponin(cTnI) and creatine kinaes BB isozyme(CK-BB) in newborns with hypoxic-ischemic encephalopathy(HIE).Methods The levels of cTnI and CK-BB in one hundred and six newborns with HIE(HIE group) and thirty-six healthy newborns(control group) were detected and comparison twenty-four hours after birth.Results The levels of serum cTnI and CK-BB in newborns with midrange and severe HIE twenty-four hours after birth were higher than those in control group(P<0.01).The level of serum CK-BB in newborns with mild HIE was higher than that in control group(P<0.05),but there was no significant difference in the level of cTnI between two groups(P>0.05).There were significant difference in the levels of serum cTnI and CK-BB among the newborns with mild,midrange and severe HIE(P<0.01).Seven and fourteen days after birth,the levels of serum cTnI and CK-BB in the newborns with NBNA score <35 points were higher than those in the newborns with neanatal behavioral neurological assessment(NBNA) score ≥35 points(P<0.01).Conclusion The levels of serum cTnI and CK-BB detection twenty-four hours after birth can be helpful to evaluate the severity of HIE and prognosis of newborns.