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目的探讨高胆红素血症对足月新生儿心肌组织的影响。方法选择46例高胆红素血症患儿为高胆组,30例健康新生儿为对照组,根据治疗方法不同将高胆组分成高胆Ⅰ组和高胆Ⅱ两组。高胆组分别于治疗前后抽取静脉血测定胆红素和心肌酶,所有患儿入院时均行心电图、超声心动图检查。结果高胆组新生儿心肌酶血清磷酸肌酸激酶同工酶(CK-MB)较对照组明显增高,差异有统计学意义(P<0.01);高胆组Ⅱ组患儿治疗前后心肌酶CK-MB比较差异无统计学意义(P>0.05);高胆组和对照组新生儿超声心动图、心电图均无明显异常,也无心肌受损的临床表现和体征。结论新生儿高胆红素血症对心肌无损害,而且无需常规保心肌治疗;临床上诊断新生儿心肌损伤仅依据心肌酶活性增高是不够的,应结合超声心动图、心电图以及临床表现来综合判断。
Objective To investigate the effect of hyperbilirubinemia on full-term neonatal myocardial tissue. Methods 46 cases of hyperbilirubinemia in children with high gall group, 30 healthy newborns as the control group, according to the different treatment methods will be divided into high-gall bladder group of high gall bile and high bile Ⅱ two groups. High gall group were taken before and after treatment venous blood bilirubin and myocardial enzyme, all children admitted to hospital underwent electrocardiogram, echocardiography. Results Compared with the control group, serum creatine phosphokinase (CK-MB) in neonates with hypercholesterolemia increased significantly (P <0.01). The levels of myocardial enzymes CK (P> 0.05). Neonatal echocardiography and electrocardiogram showed no obvious abnormality and no clinical manifestations and signs of myocardial damage in the high-gall group and the control group. Conclusion Neonatal hyperbilirubinemia does not damage the myocardium and does not require conventional cardiopulmonary bypass. Clinically, it is not enough to diagnose neonatal myocardial injury based solely on the increase of myocardial enzyme activity, which should be combined with echocardiography, electrocardiogram and clinical manifestations judgment.