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目的探讨宫内窘迫对足月新生儿血清心肌酶水平的影响。方法 2009年2月至2009年12月本院产科出生有宫内窘迫史而羊水和Apgar评分均正常的足月新生儿为观察组,同期出生的健康足月新生儿为对照组,分别测定两组生后1、4d血清cTnI及CK-MB水平。结果观察组30例,对照组16例。观察组生后1d血清cTnI高于对照组(P<0.001),CK-MB两组差异无统计学意义(P>0.05),生后4d血清cTnI及CK-MB均高于对照组(P<0.05)。观察组和对照组生后4d时血清cTnI水平均较1d时升高,差异有统计学意义(P<0.001和P<0.05);血清CK-MB浓度均低于1d时(P<0.05)。观察组生后4dcTnI浓度异常23例,经口服果糖二磷酸钠口服液痊愈14例,血清心肌酶水平恢复正常时间平均56d(23～110d)。结论单纯宫内窘迫可造成足月新生儿血清cTnI及CK-MB水平升高,常规检测血清cTnI及CK-MB能及时了解此类新生儿的心肌受损情况,从而尽早予以保护心肌治疗。
Objective To investigate the effect of intrauterine distress on serum myocardial enzymes in term neonates. Methods From February 2009 to December 2009, full-term neonates with a history of intrauterine distress and obstetrical amniotic fluid and Apgar scores were selected as observation group. Healthy full-term newborn infants born at the same period were taken as control group, Serum levels of cTnI and CK-MB at 1 and 4 days after birth. Results The observation group of 30 cases, control group of 16 cases. The level of cTnI in the observation group was significantly higher than that in the control group on the first day after birth (P <0.001), and there was no significant difference between the two groups (P> 0.05). The levels of cTnI and CK-MB in the observation group were higher than those in the control group 0.05). The levels of cTnI in the observation group and the control group at 4 days after birth were significantly higher than those at 1 day (P <0.001 and P <0.05), respectively. The serum CK-MB concentrations were all lower than those at 1 day (P <0.05). In the observation group, 23 cases were abnormal in 4dcTnI concentration after birth, and 14 cases were recovered by oral administration of fructose sodium diphosphate solution. Serum myocardial enzyme level returned to normal within 56 days (23 ~ 110 days). CONCLUSIONS: Intrauterine distress alone can cause elevated levels of serum cTnI and CK-MB in term newborns. Conventional detection of serum cTnI and CK-MB can provide timely information on myocardial damage in neonates so as to protect myocardium as soon as possible.