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目的探讨胎儿宫内窘迫对足月新生儿血清心肌酶变化的相关性分析。方法将2009年10月2010年9月在我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20例为观察组,同期出生的健康足月新生儿10例为对照组,分别测定两组出生后1、5d血清肌酸激酶同工酶(CK-MB)及心肌肌钙蛋白I(cTnI)水平。结果观察组出生后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),出生后5d血清CK-MB及cTnI均高于对照组(P<0.001);观察组和对照组出生后5d血清cTnI水平均较1d时升高,差异有统计学意义(P<0.001),血清CK-MB浓度均低于1d时(P<0.001)。观察组患儿经过治疗,1个月后复查血清cTnI除1例未恢复至正常水平外,其余血清CK-MB及心电图均恢复正常。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 correlation between fetal distress and changes of serum myocardial enzymes in term neonates. Methods Totally 20 full-term newborns with history of intrauterine distress and amniotic fluid and Apgar scores in our obstetric department from October 2009 to September 2010 were selected as the observation group. Ten healthy full-term newborns were born in the same period as the control group The levels of creatine kinase (CK-MB) and cardiac troponin I (cTnI) were measured at 1 and 5 days after birth in both groups. Results The level of cTnI in the observation group was significantly higher than that in the control group (P <0.001) at 1 d after birth, and there was no significant difference between the two groups (P> 0.05). The serum CK-MB and cTnI at 5 d after birth were significantly higher than those in the control group (P <0.001). The levels of cTnI in serum of the observation group and the control group on the 5th day after birth were both higher than those on the 1th day (P <0.001). The observation group of children after treatment, 1 month after the review of serum cTnI except 1 case did not return to normal levels, the other serum CK-MB and ECG returned to normal. 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.