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目的观察心肌酶谱在窒息后新生儿缺氧性心肌损伤中的变化及其临床意义。方法选择窒息新生儿42例,按照窒息程度分为2组,分别于生后24h内和生后第3、7天检测血清肌酸激酶(CK)、肌酸激酶同工酶(CK-MB)、乳酸脱氢酶(LDH)、α-羟丁酸脱氢酶(α-HBDH)水平,并将同期住院的非缺氧新生儿20例作为对照组进行比较分析。结果①轻度窒息组和重度窒息组患儿,出生后24h内及生后第3天的CK、CK-MB、LDH、α-HBDH均明显升高,与对照组差异有统计学意义(P<0.01);重度窒息组与轻度窒息组之间CK、CK-MB、LDH和α-HBDH差异亦有统计学意义(P均<0.01);②24h内重度窒息组与轻度窒息组CK-MB升高最为明显;生后第3天,CK和LDH、α-HBDH逐渐达高峰;第7天轻度窒息组CK、CK-MB、α-HBDH呈下降趋势,逐渐降至正常水平,而LDH仍呈升高水平,与对照组比较差异有统计学意义(P<0.01)。结论①新生儿窒息早期即有心肌酶的改变,表现缺氧程度与心肌酶水平升高呈正相关;②缺氧性心肌损害与新生儿窒息程度有相关性;③心肌酶谱检测对进一步诊断新生儿窒息后心肌损害有重要价值;④新生儿窒息应在及时复苏治疗同时进行心肌保护治疗。
Objective To observe the changes of myocardial enzymes in neonatal hypoxic myocardial injury after asphyxia and its clinical significance. Methods 42 newborns with asphyxia were selected and divided into 2 groups according to degree of asphyxia. Serum creatine kinase (CK) and creatine kinase (CK-MB) were detected 24h and 12h after birth respectively. , Lactate dehydrogenase (LDH), α-hydroxybutyrate dehydrogenase (α-HBDH) levels were compared with 20 non-hypoxic neonates hospitalized in the same period as a control group. Results ① The levels of CK, CK-MB, LDH and α-HBDH in the mild asphyxia group and the severe asphyxia group were significantly higher than those in the control group within 24 hours after birth and on the 3rd day after birth (P <0.01). There were also significant differences in CK, CK-MB, LDH and α-HBDH between severe asphyxia group and mild asphyxia group (all P <0.01) MB on the 3rd day after birth, CK and LDH, α-HBDH gradually reached its peak. On the 7th day, CK, CK-MB and α-HBDH in mild asphyxia group decreased gradually and gradually decreased to normal level LDH still showed an elevated level, compared with the control group, the difference was statistically significant (P <0.01). Conclusion ① myocardial enzymes in early neonatal asphyxia change, the performance of hypoxia and myocardial enzyme levels were positively correlated; ② hypoxic myocardial damage and neonatal asphyxia degree of correlation; ③ myocardial enzyme-linked immunosorbent assay for further diagnosis of newborns Asphyxia myocardial damage has an important value; neonatal asphyxia should be timely recovery treatment of myocardial protection therapy.