新生儿病理性黄疸心肌酶及肌钙蛋白I检测结果分析

目的探讨新生儿病理性黄疸时心肌酶及肌钙蛋白的变化。方法测定75例新生儿病理性黄疸患儿(观察组)及40例足月健康新生儿(对照组)血清胆红素和心肌酶及肌钙蛋白的变化。对61例观察组和40例对照组新生儿行心电图、心脏超声心动图检查,观察有无心肌受损表现。将新生儿病理性黄疸患儿分为磷酸肌酸治疗组和非治疗组,测定其急性期及恢复期心肌酶及肌钙蛋白的变化。结果 观察组血清总胆红素和心肌酶及肌钙蛋白均较对照组高(P<0.05或0.01)。观察组与对照组心电图结果均符合国内健康新生儿标准,未出现心肌受损的临床表现。观察组新生儿应用磷酸肌酸1 g/d治疗3~5 d后复查CK、CK-MB、cTnI均显著下降(P<0.01或0.05);而未应用磷酸肌酸而予常规蓝光照射治疗3 d后复查CK、CK-MB、cTnI值,治疗前后差异无统计学意义(P>0.05)。结论病理性黄疸对新生儿心肌具有一定损害,但并不严重;有条件时可进行营养心肌治疗,以帮助患儿心肌损害尽快恢复。

Influence of pathological jaundice on myocardial enzymes and cTn I in neonates

Objective To explore the changes in the levels of myocardial enzymes and cTn1 in pathological jaundice of neonates.Methods Seventy neonates with pathological jaundice were enrolled into trial group,while 40 healthy full-term neonates into control group.The levels of myocardial enzymes and cTn1 in both the groups were compared and analyzed clinically.Heart echocardiogram and ECG were recorded and clinical manifestations of myocardial damage were observed.The trial group was divided into two sub-groups according to the therapy with or without creatinine phosphate(CP).The changes in the levels of myocardial enzymes and cTn1 were detected and analyzed in acute stage and in convalescent stage.Results The levels of blood myocardial enzymes and cTn1 showed an obvious increase in the trial group(P<0.05 or P<0.01).There was no apparent abnormality such as T wave change and sinus tachycardia in ECG in the trial group,and the indexes of heart echocardiogram were in accordance with the health standard.No myocardial impaired manifestation and signs were found clinically.Neonates with CP therapy showed an obvious declination in the indexes of CK,CK-MB,cTn1;on the contrary,the indexes remained stable in those who received regular blue light therapy(without CP).Conclusion There is obvious damage to myocardia in the neonates with pathological jaundice,and CP therapy is helpful to the recovery of myocardial damage.