新生儿缺氧缺血性脑病血清肌酸激酶及其同工酶的临床观察

目的探讨新生儿缺氧缺血性脑病(HIE)时血清肌酸激酶(CK)和心型同工酶(CK-MB)、脑型同工酶(CK-BB)的动态变化及其意义。方法对2006年5月~2007年1月的41例HIE患儿和37例正常新生儿分别在生后24 h内、第3天、第7天采集股静脉血,测定血清中总CK、CK-MB及CK-BB。结果(1)HIE组血清CK、CK-MB、CK-BB水平均高于对照组(P<0.05)。(2)中、重度HIE组血清CK、CK-MB与对照组和轻度HIE组比较有显著性差异(P<0.01)。轻度HIE组血清CK、CK-MB与对照组比较无统计学意义(P>0.05)。轻、中、重度HIE组血清CK-BB与对照组比较差异均显著(P<0.01)。结论(1)HIE血清中CK、CK-MB、CK-BB水平与HIE程度密切相关,HIE程度越重其水平越高。(2)血清CK、CK-MB、CK-BB是HIE患儿心、脑损伤的早期敏感指标,可作为对HIE的早期诊断、病情严重程度判定常用的指标;对临床进行干预治疗和早期估计预后具有重要的意义。

The study of the dynamic changes of creatine kinase and its isoenzyme in neonates with hypoxic-ischemia encephalopathy

Objective To explore the dynamic changes of creatine kinase,brain specific isoenzyme(CK-BB) and MB isoenzyme of creatine kinase(CK-MB) in neonates with hypoxic ischemic encephalopathy(HIE) and further explore the clinical sense.Methods Forty-one neonates with HIE were treated in Taian Center Hospital from May 2006 to January 2007,and 37 normal neonates were involved in the study.The HIE group and the control group were drawn blood 24 hours after birth,on the third day and the seventh day.The serum level of CK、CK-MB and CKBB was measured.Results(1) The serum levels of CK,CK-MB and CK-BB in infants with HIE were higher than that in control(P<0.05).(2) There was significant difference of serum CK,CK-MB levels between moderate,severe HIE and control mild HIE.There was no significant difference between mild HIE and control group about the serum CK,CK-MB levels.The serum CK-BB levels of mild,moderate and severe HIE were all positively higher than that of control group(P<0.01).Conclusion The present data suggests that the changes of serum CK,CK-MB and CK-BB levels are related to se-verityand became higher and higher with the worsening condition of HIE.They all peaked within 24 hours afterbirth,then began to decrease gradually from the third day.The serum CK,CK-MB and CK-BB levels of moderate HIE reduced to normal on the seventh day.Severe HIE decreased obviously at the seventh day but was still significantly higher than that in control(P<0.01).of HIE.They are the early distinctive and specific markers of brain-heart damage.The dynamic changes of serumCK,CK-MB and CK-BB levels are of great value in assessing prognosis,early diagnosis,determining the degree and performing treatment for HIE.