血清总胆红素动态变化对新生儿心肌酶的影响

目的:探讨血清总胆红素动态变化对新生儿心肌酶改变的影响.方法:选择新生儿黄疸患儿227例,参照新生儿高胆红素血症的诊断标准分为生理性黄疸组(生理组)60例,病理性黄疸组(病理组)167例;病理组根据血清总胆红素(TBIL)浓度不同,分为A(TBIL 230～300 μmol·L-1)、B(TBIL 301～350 μmol·L-1)、C(TBIL>351 μmol·L-1)3个亚组,检测各组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)含量.结果:病理组中B、C亚组AST、CK、CK-MB水平明显高于生理组,差异有统计学意义(P<0.05或P<0.01);B、C亚组AST、CK-MB、LDH水平高于A亚组,差异有统计学意义(P<0.05或P<0.01).结论:黄疸能引起心肌酶发生改变,高浓度胆红素可致心肌受损.

Influence of serum total bilirubin in dynamic change on the neonate myocardial enzymes

Objective: To investigate the influence of serum total bilirubin in dynamic change on the neonate myocardial enzymes.Methods: 227 cases of infant patients with icterus neonatorum were chosen,and were divided into two groups referring to diagnostic standard of newborn hyperbilirubinemia: physiologic jaundice group(physiologic group,60 cases) and pathologic jaundice group(pathologic group,167 cases).Cases in the pathologic group were divided into group A(230~300 μmol·L-1),B(301~350 μmol·L-1) and C(>350 μmol·L-1) according to the concentration of serum total bilirubin.Serum AST,LDH,CK,CK-MB in each group were detected.Results: There was a significant difference in comparing the group B,C and physiologic group by AST,CK,CK-MB(P<0.05 or P<0.01).In the pathologic group,AST,CK-MB,LDH in group B and C showed higher than that of group A,there was significantly different(P<0.05 or P<0.01).Conclusion: Icterus could change myocardial enzymes,bilirubin in high concentration might cause cardiac damage.