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目的 探讨新生儿缺氧缺血性脑病 (HIE)患儿QT间期离散度 (QTcd)和肌酸激酶同功酶 (CK -MB)的动态变化及相关性。方法 对 41例新生儿HIE发病 2 4～ 48小时和治疗 10～ 14天后QTcd和CK -MB值进行检测。并与 2 0例无窒息新生儿对照组比较。结果 发病 48小时内与对照组比较 ,新生儿HIE各组QTcd和CK -MB值显著上升 (P <0 0 5 ,P <0 0 1)。与轻、中度HIE比较 ,重度HIEQTcd和CK -MB值显著上升 (P <0 0 1) ,但轻度HIE与中度HIE比较 ,亦有显著性差异 (P <0 0 5 )。治疗后 ,轻度、中度HIEQTcd和CK -MB值均有显著下降 ,与治疗前比较均有显著性差异 (P <0 0 1) ,重度HIE治疗前后比较无显著性差异 (P >0 0 5 )。QTcd与CK -MB呈正相关 (r =0 6 9,P <0 0 1)。结论 QTcd可作为判断新生儿HIE病情轻重 ,评价心脏损害的一项客观指标
Objective To investigate the dynamic changes of QTcd and creatine kinase isoenzyme (CK-MB) in neonates with hypoxic-ischemic encephalopathy (HIE). Methods Twenty-one newborns with HIE were enrolled in this study. QTcd and CK-MB were measured after 24-48 hours and 10-14 days of treatment. And compared with 20 neonatal asphyxia control group. Results Compared with the control group, the values of QTcd and CK-MB in neonates with HIE increased significantly within 48 hours after onset (P <0.05, P <0.01). Compared with mild and moderate HIE, severe HIEQTcd and CK-MB increased significantly (P <0.01), but there was also a significant difference between mild HIE and moderate HIE (P <0.05). After treatment, mild and moderate hypodermic HIEQTcd and CK-MB values were significantly decreased compared with before treatment were significantly different (P <0.01), before and after treatment of severe HIE no significant difference (P> 0 0 5). QTcd was positively correlated with CK-MB (r = 0.69, P <0.01). Conclusion QTcd can be used as an objective indicator to evaluate the severity of neonatal HIE and evaluate the cardiac damage