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目的通过对比研究,分析缺血修饰白蛋白(IMA)、肌酸激酶同工酶(CK-MB)在新生儿窒息患者中的变化,探讨两者对新生儿窒息合并心肌损伤的早期诊断价值。方法以162例新生儿窒息患儿为研究对象,其中心肌损伤74例(损伤组),非心肌损伤88例(非损伤组);轻度窒息96例(轻度窒息组),重度窒息66例(重度窒息组)及健康组84例分别于出生后3 h和6 h采血,检测IMA实验ACB值(白蛋白钴结合力),同时检测CK-MB,比较各组ACB值与CK-MB的变化。结果损伤组3 h、6 h的ACB值均明显低于健康组、非损伤组(P<0.01),损伤组6h与3h的ACB值比较差异无意义(P>0.05);重度窒息组3 h和6 h的ACB值均明显低于轻度窒息组、健康组(P<0.01),重度窒息组6 h与3 h的ACB值比较差异无意义(P>0.05)。结论 IMA可以作为发生缺血的标志物和心肌缺血程度的优秀指标,可在新生儿窒息发生早期预测心肌损伤的发生,并在鉴别窒息程度中发挥作用。而CK-MB可用于判断心肌坏死。相较之下,IMA比CK-MB具有更高的早期诊断价值。
Objective To compare the changes of ischemic-modified albumin (IMA) and creatine kinase isoenzyme (CK-MB) in neonates with asphyxia through comparative study and to explore the early diagnostic value of IMA and CK-MB in neonatal asphyxia with myocardial injury. Methods Totally 162 neonates with asphyxia were studied, including 74 cases of myocardial injury (injury group), 88 cases of non-myocardial injury (non-injury group), 96 cases of mild asphyxia (mild asphyxia group) and 66 cases of severe asphyxia (Severe asphyxia group) and healthy group (84 cases) were collected at 3 h and 6 h after birth, respectively. The ACB value (albumin cobalt binding) of IMA was measured and CK-MB was detected. The ACB value and CK-MB Variety. Results ACB values at 3 h and 6 h after injury in the injury group were significantly lower than those in the healthy and non-injury groups (P <0.01), while ACB values at 6 and 3 h after injury were insignificant (P> 0.05) (P <0.01). There was no significant difference in ACB value between 6 h and 3 h in severe asphyxia group (P> 0.05). Conclusion IMA can be used as a good indicator of ischemia and myocardial ischemia, which can predict the occurrence of myocardial injury in the early stage of neonatal asphyxia and play an important role in the identification of asphyxia. The CK-MB can be used to determine myocardial necrosis. In contrast, IMA has a higher early diagnostic value than CK-MB.