论文部分内容阅读
目的探讨轻度窒息新生儿动态心电图(AECG)、心肌酶变化特点及其临床意义。方法选取2011年6月至2013年8月我院新生儿科收治的轻度窒息新生儿为窒息组,同期选择本院分娩的30例健康新生儿为对照组,均于生后24 h内行AECG检查,于出生18~24 h内抽取静脉血测定血清肌酸磷酸激酶(CK)、血清肌酸磷酸激酶同工酶(CK-MB)、血清乳酸脱氢酶(LDH)、血清谷草转氨酶(AST)、心肌肌钙蛋白(cTnI)。结果窒息组(46例)与对照组(30例)新生儿AECG窦性心律指标(最慢心率、最快心率、平均心率)差异均无统计学意义(P>0.05);窒息组ST段改变及心律失常等其他几项综合指标(包括房早、房速、室早、Q-T间期延长、交界性逸搏)异常发生率高于对照组(65.2%比16.7%,89.1%比13.3%,P均<0.01)。窒息组心肌酶指标及cTnI值均高于对照组[CK(604.7±275.4)比(162.0±95.1),CK-MB(87.9±61.0)比(28.3±27.1),LDH(686.0±383.5)比(310.7±133.5),AST(95.0±63.1)比(35.2±13.9),cTnI(0.12±0.11)比(0.02±0.01),P均<0.01]。窒息组CK、CK-MB、LDH、AST异常发生率高于对照组(63.0%比16.7%,82.6%比6.7%,95.7%比20.0%,32.6%比6.7%,P均<0.01)。结论轻度窒息新生儿AECG监测可发现各种心律失常、ST段改变,其心肌酶亦明显高于正常新生儿,ST段改变及CK-MB的升高是诊断轻度窒息新生儿心肌损伤的可靠依据。
Objective To investigate the changes of myocardial enzymes and their clinical significance in mild asphyxia neonate with dynamic electrocardiogram (AECG). Methods From June 2011 to August 2013, neonatal asphyxia neonates admitted to neonatal department of our hospital were asphyxia group. 30 healthy newborn infants in our hospital were selected as the control group in the same period. All patients underwent AECG examination within 24 hours after birth. , Serum creatine phosphokinase (CK), serum creatine phosphokinase (CK-MB), serum lactate dehydrogenase (LDH), serum aspartate aminotransferase (AST) were measured at 18 ~ , Cardiac troponin (cTnI). Results There was no significant difference in AECG sinus rhythm index (slowest heart rate, fastest heart rate, average heart rate) between asphyxia group (46 cases) and control group (30 cases) (P> 0.05) And arrhythmia and other several comprehensive indicators (including atrial early, atrial tachycardia, premature ventricular tachycardia, QT interval prolongation, junctional esophageal stroke) abnormal incidence was higher than the control group (65.2% vs 16.7%, 89.1% vs 13.3% P <0.01). The indexes of myocardial enzymes and cTnI in asphyxia group were higher than those in control group (CK (604.7 ± 275.4) vs (162.0 ± 95.1), CK-MB (87.9 ± 61.0) vs (28.3 ± 27.1), LDH 310.7 ± 133.5), AST (95.0 ± 63.1), (35.2 ± 13.9) and cTnI (0.12 ± 0.11), respectively (all P <0.01). The incidence of abnormal CK, CK-MB, LDH and AST in asphyxia group was higher than that in control group (63.0% vs 16.7%, 82.6% vs 6.7%, 95.7% vs 20.0%, 32.6% vs 6.7%, P <0.01). Conclusion Asphyxia neonatorum AECG can detect all kinds of arrhythmia, ST segment changes, and its myocardial enzymes were also significantly higher than normal newborns, ST segment changes and elevated CK-MB in the diagnosis of mild asphyxia neonatal myocardial injury Reliable basis.