新生儿窒息脐血中血清心肌酶的变化

目的探讨新生儿窒息早期脐血血清心肌酶的变化与新生儿缺氧程度的关系。方法选择临产后出现急性胎儿窘迫孕妇60例，其中出现新生儿窒息的30例为窒息组，娩出后胎儿正常的30例为窘迫组；另外选择正常足月孕妇30例为对照组。胎儿娩出后迅速进行1minApgar评分和脐血PH值检测，判定是否出现新生儿窒息，然后检测脐血血清心肌酶水平。结果窒息组患儿脐血天冬氨酸转氨酶（AST）、乳酸脱氢酶（LDH）、肌酸激酶（CK）、肌酸激酶心肌同工酶（CK-MB）均高于窘迫组但差异性不显著（P〉0．05），窒息组患儿脐血CK-MB、LDH明显高于对照组差异有显著性（P〈0．05）。结论缺氧窒息可致血清酶活性增高，且增高程度与缺氧程度有一定的关联性，窒息早期脐血中血清心肌酶的变化值得关注。

The changes of serum myocardial enzymes in umbilical cord blood from cases subjected to fetal distress

Objective The aim of present study is to investigate the relationship between the degree of oxygen deficiency and serum myocardial enzymes of umbilical venous. Methods Sixty cases subjected to acute fetal distress were divided into fetal distress group in which the neonatus is normal and asphyxia neonatorum group in which the neonatus has asphyxiation with thirty in each group. Thirty cases that pregnant woman and neonatus were both healthy served as control. After childbirth, the Apgar score of 1 minute and PH values of umbilical cord blood were measured quickly for the determination of neonatal asphyxia. Subsequently levels of serum myocardial enzymes of umbilical venous were detected. Results There were no statistically significant differences in activities of aspartate aminotransferase （AST）, lactate dehydrogenase （LDH）, creatine kinase （CK） and creatine kinase of MB type （CK-MB） between fetal distress group and asphyxia neonatorum group （P 〉 0. 05）. Activities of CK-MB and LDH in asphyxia neonatorum group were increased obviously compared with those of fetal distress group （P 〈 0.05 ）. Conclusion Asphyxiation can lead to an increase of activities of serum myocardial enzymes in umbilical cord blood. Moreover, the change of these myocardial enzyme activities is related to the degree of oxygen deficiency.