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目的探讨新生儿缺氧后心肌损害的临床特征和治疗体会。方法对38例HIE伴心肌损害的患儿出生后48 h内测定血清天门冬氨酸基转移酶(AST)、乳酸脱氢酶(LDH)、磷酸肌酸激酶(CK)、磷酸肌酸激酶同工酶(CK-MB)的活性,综合治疗10 d,复查血清心肌酶谱并做对比分析。结果 HIE患儿各有不同临床表现,并有血清心肌酶谱各项指标不同程度增高,38例中AST升高者19例,指标范围在41.0～112.3 U/L;LDH升高者38例,指标范围在116.0～944.3 U/L;CK升高者38例,指标范围在581.0～695.1 U/L;CK-MB升高者38例,指标范围在148.9～193.7 U/L。除1例中途放弃治疗外,其余37例患儿治疗后心肌酶谱均下降(P<0.01)。结论 HIE患儿入院后应常规行血清心肌酶谱方面的检测,以早期发现心肌损害,早期干预治疗。
Objective To investigate the clinical features and treatment of neonatal hypoxic myocardial damage. Methods Serum aspartate aminotransferase (AST), lactate dehydrogenase (LDH), creatine phosphokinase (CK) and creatine phosphokinase (CK) in 38 HIE patients with myocardial damage Enzyme (CK-MB) activity, comprehensive treatment of 10 d, review of serum myocardial enzymes and make a comparative analysis. Results There were different clinical manifestations in children with HIE, and various indexes of serum myocardial enzymes increased to varying degrees. Among 38 cases, 19 cases were elevated in AST with the range of 41.0-112.3 U / L; 38 cases had elevated LDH, The index ranged from 116.0 to 944.3 U / L, CK elevated in 38 cases, index ranged from 581.0 to 695.1 U / L, elevated CK-MB in 38 cases, and index ranged from 148.9 to 193.7 U / L. Except for one case, the myocardial enzymes were decreased after treatment in 37 cases (P <0.01). Conclusions Children with HIE should be routinely tested for serum myocardial enzymes after admission, with early detection of myocardial damage and early intervention.