G6PD缺乏对新生儿高胆红素血症患儿心肌酶的影响

目的研究葡萄糖6磷酸脱氢酶（G6PD）缺乏是否会加重新生儿高胆红素血症患儿的心肌损伤从而影响患儿血液中心肌酶的水平。方法选取2012年10月至2013年11月在我院出生的新生儿黄疸患儿190例，经检查后分组，将其中139例高胆红素血症患儿分为观察组，余51例生理性黄疸患儿分为对照组；观察组患儿根据G6PD是否正常再分为观察Ⅰ组79例（G6PD正常）和观察Ⅱ组60例（G6PD缺乏），抽血检测所有患儿总胆红素（TBIL）、葡萄糖6磷酸脱氢酶（G6PD）、谷草转氨酶（AST）、乳酸脱氢酶（LDH）、肌酸激酶（CK）以及肌酸激酶同工酶（CK-MB），并对检测结果进行比较分析。结果观察组中139例患儿的平均血清TBIL含量（269．7±31．3）μmol／L]明显高于对照组（186．5±19．8）μmol／L]，两者比较差异具有统计学意义（P〈0．05）；观察组患儿血清中AST、LDH、CK、CK-MB等心肌酶的平均含量均明显高于对照组，差异均具有统计学意义（P〈0．05）；观察Ⅱ组患儿与观察Ⅰ组患儿胆红素水平含量比较差异无统计学意义（P〉0．05），但观察Ⅱ组患）LAST、CK、CK-MB、LDH等心肌酶的平均含量均明显高于观察Ⅰ组，差异均具有统计学意义（P〈0．05）。结论高胆红素血症可以对心肌细胞造成损伤从而引起心肌酶水平的变化，新生儿高胆红素血症患儿的心肌酶升高程度与其黄疸水平呈正相关；G6PD缺乏可增强高胆红素血症对心肌细胞造成的损伤。

Influence of glucose-6-phosphate dehydrogenase deficiency on myocardial enzyme in patients with neonatal hyperbilirubinemia

Objective To explore whether the glucose-6-phosphate dehydrogenase （G6PD） deficiency will aggravate the myocardial injury in patients with neonatal hyperbilirubinaemia and influence the levels of neonate myocardial enzymes. Methods A total of190 children with hyperbilirubinemia who were born in our hospital from 2012 October to 2013 November were involved in this study. After examination, they were divided into observation group （139 children） and control group （51 children）. According to the G6PD level, the observation group was divided into observation group Ⅰ （79 cases with normal G6PD） and observation group lI （60 cases with G6PD deficiency）. TBIL, G6PD, AST, LDH, CK and CK-MB in the 190 children were detected and analyzed. Results The average content of TBIL in the observation group was significantly higher than that in the control group （269.7 ± 31.3） μmol/L vs （186.5±19.8） μmol/L, P〈0.05]. The average contents ofAST, LDH, CK and CK-MB in the observation group was significantly higher than those in the control group （P〈0.05）; There was no significant difference in the average content of TBIL between the observation group I and the observation group Ⅱ （P〉0.05）, but the average contents ofAST, LDH, CK and CK-MB in the observation group Ⅱ was significantly higher than that in the observation group Ⅰ（P〈0.05）. Conclusion Hyperbilirubinemia damaged myocardial cells and changed the myocardial enzyme content in serum. The myocardial enzyme level in patient with neonatal hyperbilirubinemia was positively correlated with jaundice. G6PD deficiency increased the damage on myocardial cells.