论文部分内容阅读
目的探讨新生儿缺氧缺血性脑病(HIE)时血清肌酸激酶(CK)和心型同工酶(CK-MB)、脑型同工酶(CK-BB)的动态变化及其意义。方法对2004-05—2005-01的32例HIE患儿和30例正常新生儿分别在生后24h内、第3天、第7天采集股静脉血,测定血清中总CK、CK-MB及CK-BB。结果(1)HIE组血清CK、CK-MB、CK-BB水平均高于对照组(P<0.05)。HIE各组血清CK、CK-MB、CK-BB水平均随着病情加重而升高,生后24h内均达到峰值,第3天开始下降,第7天中度组CK、CK-MB、CK-BB降至正常水平,重度组CK、CK-MB、CK-BB仍明显高于对照组(P<0.01)。(2)中、重度HIE组血清CK、CK-MB与对照组和轻度HIE组比较有显著性差异(P<0.01)。轻度HIE组血清CK、CK-MB与对照组比较无统计学意义(P>0.05)。轻、中、重度HIE组血清CK-BB与对照组比较差异均显著(P<0.01)。结论(1)HIE血清中CK、CK-MB、CK-BB水平与HIE程度密切相关,HIE程度越重其水平越高。(2)血清CK、CK-MB、CK-BB是HIE患儿心、脑损伤的早期敏感指标,可作为对HIE的早期诊断、病情严重程度判定常用的指标;对临床进行干预治疗和早期估计预后具有重要的意义。
Objective To investigate the dynamic changes of serum creatine kinase (CK), cardiotrophin (CK-MB) and brain-type isoenzyme (CK-BB) in neonates with hypoxic-ischemic encephalopathy (HIE) Methods 32 cases of HIE children and 30 normal newborns from 2004-05-2005-01 were collected at 24h, 3d and 7d after birth respectively. The femoral vein blood was collected for determination of total CK, CK-MB, CK-BB. Results (1) Serum levels of CK, CK-MB and CK-BB in HIE group were significantly higher than those in control group (P <0.05). The levels of serum CK, CK-MB and CK-BB in HIE groups increased with the severity of the disease, peaked within 24 hours after birth, and began to decline on the 3rd day. On the 7th day, CK, CK-MB and CK -BB to the normal level, CK, CK-MB and CK-BB in the severe group were still significantly higher than those in the control group (P <0.01). (2) Serum CK and CK-MB in moderate and severe HIE group were significantly different from those in control group and mild HIE group (P <0.01). Mild HIE group serum CK, CK-MB compared with the control group was not statistically significant (P> 0.05). The levels of serum CK-BB in mild, moderate and severe HIE group were significantly different from those in control group (P <0.01). Conclusions (1) The levels of CK, CK-MB and CK-BB in HIE serum are closely related to the degree of HIE. The higher the level of HIE, the higher the level of HIE. (2) Serum CK, CK-MB and CK-BB are early sensitive indicators of heart and brain injury in children with HIE, which can be used as a common indicator for the early diagnosis of HIE and the determination of the severity of the disease. The clinical intervention and early estimation The prognosis is of great significance.