肌酸激酶同工酶对围产期窒息程度和短期预后的预测价值

目的评估血清肌酸激酶同工酶（CK-MB）的变化与围产期窒息程度及短期预后的相关性。方法采用前瞻性序贯试验研究方案,随机选择245例足月新生儿为研究对象,比较142例窒息新生儿和103例正常新生儿血清CK-MB水平差异,评估CK-MB与围产期窒息严重度指标1min Apgar评分、脐动脉血pH及其短期预后的相关性。结果窒息组CK-MB水平显著高于正常对照组,差异比较有统计学意义（P〈0.001）。CK-MB与围产期窒息严重度指标1min Ap-gar评分和脐动脉血pH呈负相关（P〈0.001）,与围产期窒息短期不利预后呈正相关（P〈0.001）。结论血清CK-MB有助于早期预测围产期窒息程度和短期预后。

Value of creatine kinase isoenzyme in predicting severity and short term prognosis of perinatal asphyxia

Objective: Perinatal asphyxia is a major cause of neurologic morbidity and mortality.The purpose of this study was to investigate variations in serum creatine kinase isoenzymes(CK-MB) associated with perinatal asphyxia and its relationship to both the severity and short term prognosis of asphyxia.Methods: The prospective sequential trial design was conducted on 245 selected randomly term infants.Levels of serum CK-MB were compared for 142 asphyxiated(case group) and 103 normal neonates(control group).These parameters were also related to the severity of asphyxia and clinical short-term outcome.Results: The levels of serum CK-MB in the case group were significantly greater than the corresponding values in the controls(P<0.001).A statistically significant negative correlation existed between CK-MB and indicators of the severity of perinatal asphyxia,first minute Apgar score and umbilical arterial pH(P<0.001),respectively.A positive correlation was demonstrated between these parameters and poor outcome(P<0.001).Conclusions: Serum CK-MB is a useful predictor of severity and short-term outcome of perinatal asphyxia.