心肌酶谱在新生儿缺氧缺血性脑病时的变化及临床意义

目的探讨新生儿缺氧缺血性脑病(HIE)时血浆心肌酶谱的变化及临床意义。方法将54例HIE患儿分轻、中、重度组与41例正常新生儿脐血对照,分别采用连续监测法和免疫比浊法测定血浆中天门冬氨酸氨基转移酶(AST)、乳酸脱氢酶(LDH)、肌酸激酶(CK)、肌酸激酶同工酶(CK-MB)和α-羟丁酸脱氢酶(α-HBDH)的活性,并进行统计分析。结果HIE时血浆AST、LDH、CK、α-HBDH活性随着病情的加重而相应升高,尤以CK、CK-MB升高明显,与临床分度呈正相关。重度组较正常对照组明显升高,差异有显著性(P<0.01);中度组除CK-MB外,其余酶活性较正常对照组明显升高,差异有显著性(P<0.01);轻度组与正常对照组比较差异均无显著性。结论心肌酶谱的检测可作为HIE临床分度的指标之一。监测患儿心肌酶谱的变化,能较好地协助临床早期诊断HIE时有无心肌损伤及损伤程度,对判断病情、估计预后具有重要的临床意义。

Changes of Myocardial Enzymogram in Neonatal Hypoxic-ischemic Encephalopathy and Its Clinical Significance

Objective To evaluate the changes of myocardial enzymogram in neonatal hypoxic-ischemic encephalopathy(HIE) and its clinical significance.Methods 54 cases with HIE were divided into three groups: slight group,moderate group and severe group.The myocardial enzymes in plasma,including AST,LDH,CK,CKMB and a-HBDH,were detected by dynamic method and immunonephelometry respectively and compared with 41 cases normal individuals(control).So did these of the control.The statistical tests were done with the results.Results The activity of AST,LDH,a-HBDH,especially CK and CK-MB increased significantly in HIE patients compared with the normal control(P<0.01),and related with the disease process.The level of all enzymes in the severe group and except CK-MB in the moderate group increased obviously and was higher than that in the control(P<0.01).Conclusions The myocardial enzymogram can be used as one of markers for HIE grading,and is helpful to the early treatment of myocardial damage and the evaluation of the state and prognosis of HIE.