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目的探讨窒息早产儿血浆N末端脑钠肽(NT-proBNP)水平及肺动脉血流参数变化。方法利用ELISA法测定60例窒息和20例无窒息早产儿血浆NT-proBNP和肌酸激酶心肌型同功酶(CK-MB)水平,并应用多普勒超声检测各组早产儿主、肺动脉血流参数,分析上述结果在诊断窒息早产儿心功能障碍中的价值。结果轻度和重度窒息组早产儿血浆NT-proBNP水平(pmol/L)均高于对照组[(217±46)、(359±56)比(123±25),P分别<0.05和0.01],重度窒息组高于轻度窒息组(P<0.05);重度窒息组CK-MB水平高于对照组(P<0.05),与轻度窒息组差异无统计学意义,轻度窒息组与对照组差异无统计学意义(P均>0.05)。轻度和重度窒息组肺动脉射血加速时间(AT)及其与肺动脉射血时间(ET)的比值(AT/ET)较对照组均缩短或降低(P分别<0.05和0.01);重度窒息组较轻度窒息组缩短或降低明显(P<0.05)。结论窒息早产儿血浆NT-proBNP水平升高,肺动脉AT及AT/ET值缩短或降低。
Objective To investigate the changes of plasma N-terminal pro brain natriuretic peptide (NT-proBNP) levels and pulmonary blood flow parameters in asphyxiated premature infants. Methods The levels of plasma NT-proBNP and CK-MB in 60 asphyxiated and 20 premature infants without asphyxia were measured by ELISA. The levels of plasma CK-MB in the preterm infants were measured by Doppler sonography. Flow parameters, analysis of the above results in the diagnosis of asphyxia in preterm infants, the value of cardiac dysfunction. Results The levels of plasma NT-proBNP (pmol / L) in preterm infants with mild and severe asphyxia were significantly higher than those in controls (217 ± 46, 359 ± 56, 123 ± 25, P <0.05 and 0.01, respectively) , Severe asphyxia group was higher than mild asphyxia group (P <0.05); severe asphyxia group CK-MB level was higher than the control group (P <0.05), and mild asphyxia group was no significant difference, mild asphyxia group and control There was no significant difference between the two groups (P> 0.05). Compared with control group, AT / ET and AT / ET of pulmonary arterial ejection fraction (AT) in mild and severe asphyxia group were both shorter or lower than those in control group (P <0.05 and 0.01 respectively); severe asphyxia group Mild asphyxia group decreased or decreased significantly (P <0.05). Conclusion The plasma NT-proBNP level in preterm infants with asphyxia increases and the AT and AT / ET values in pulmonary artery decrease or decrease.