超敏C—反应蛋白、心肌酶测定与新生儿窒息程度的关系分析(1)
[摘要] 目的 探讨超敏C-反应蛋白(hs-CRP)、心肌酶测定与新生儿窒息程度的关系。 方法 选取2012年1月～2014年12月本院收治的123例窒息新生儿，根据出生后1 min内的新生儿Apgar评分，其中42例为重度窒息组，81例为轻度窒息组；选取本院同期顺产分娩的健康无窒息新生儿30例为对照组。3组新生儿在出生24 h内抽静脉血，测定血清中hs-CRP和心肌酶(AST、LDH、CK、CK-MB、α-HBDH)，并作对比分析。 结果 重度窒息组的hs-CRP和心肌酶指标均高于轻度窒息组，差异有统计学意义(P<0.05)；轻度窒息组的hs-CRP和心肌酶指标均高于对照组，差异有统计学意义(P<0.05)。 结论 hs-CRP和心肌酶在窒息新生儿中均显著升高，且升高程度与窒息程度成正相关，可作为心肌损害及严重程度的评估指标。hs-CRP与心肌酶的测定对新生儿窒息所致心肌损害的早期诊断和预后评估有重要的临床价值。
[关键词] 超敏C-反应蛋白；心肌酶；新生儿窒息
[中图分类号] R722.12 [文献标识码] A [文章编号] 1674-4721(2015)07(c)-0103-03
The relevance between the degree of neonatal asphyxia and the determination of high sensitivity C-reactive protein and myocardial enzyme
XU Jian-min ZHOU Li-yin ZHAN Guo-hao
Clinical Laboratory，Maternal and Child Health Hospital of Yunfu City in Guangdong Province，Yunfu 527300，China
[Abstract] Objective To investigate the relevance between the degree of neonatal asphyxia and the determination of high sensitivity C-reactive protein(hs-CRP) and myocardial enzyme. Methods 123 cases of neonatal suffocation admitted into our hospital from January 2012 to December 2014 were selected.According to born within 1 min after the neonatal Apgar score，42 cases as severe asphyxia group and 81 cases as mild asphyxia group.30 cases of healthy and without asphyxia newborn baby at the same period in our hospital were selected as control group.Three groups were phlebotomized within 24h after birth to determine serum hs-CRP and myocardial enzyme(AST，LDH，CK，CK-MB，α-HBDH) for comparative analysis. Results The hs-CRP and myocardial enzyme in the severe asphyxia group were higher than those in the mild asphyxia group，the difference was statistically significant(P<0.05).The hs-CRP and myocardial enzyme in the mild asphyxia group were higher than those in the control group，the difference was statistically significant(P<0.05). Conclusion Both hs-CRP and myocardial enzyme were increased in asphyxial newborns.The degrees of elevation are positively correlated with the degrees of asphyxia，which can be used as the indexes of evaluating myocardial damage and its severity.The determination of hs-CRP and myocardial enzyme has an important clinical value in the early diagnosis and prognostic evaluation on the myocardial damage caused by neonatal asphyxia.
[Key words] High sensitivity C-reactive protein；Myocardial enzyme；Neonatal asphyxia
新生儿窒息是指婴儿出生时无呼吸或呼吸抑制导致低氧血症及混和性酸中毒从而出现的临床症候群，是新生儿常见的危急重症，也是新生儿至残及死亡的主要原因之一。窒息所致的缺血缺氧引起低氧血症、高碳酸血症和酸中毒等病理变化，可致脑、心、肾、肝、胃肠道等多器官发生不同程度的损害，特别是心脏受损较为常见。窒息所至的新生儿早期心肌受损在临床无明显的特异性表现，尤其是轻度窒息患儿，一般情况下早期常无明显异常，容易造成漏诊、误诊，因此，为了对窒息新生儿的心肌损害做出早期诊断，以便及时采取有针对性的干预和治疗，使患儿得到最大程度康复，防止并发症的发生，本研究对123例窒息新生儿的血清超敏C-反应蛋白(hs-CRP)和心肌酶浓度进行检测，以探讨其与新生儿窒息程度的关系，为早期诊断和早期治疗新生儿窒息引起的心肌损伤提供理论依据。, http://www.100md.com(徐建民 周丽银 湛国豪)
[关键词] 超敏C-反应蛋白；心肌酶；新生儿窒息
[中图分类号] R722.12 [文献标识码] A [文章编号] 1674-4721(2015)07(c)-0103-03
The relevance between the degree of neonatal asphyxia and the determination of high sensitivity C-reactive protein and myocardial enzyme
XU Jian-min ZHOU Li-yin ZHAN Guo-hao
Clinical Laboratory，Maternal and Child Health Hospital of Yunfu City in Guangdong Province，Yunfu 527300，China
[Abstract] Objective To investigate the relevance between the degree of neonatal asphyxia and the determination of high sensitivity C-reactive protein(hs-CRP) and myocardial enzyme. Methods 123 cases of neonatal suffocation admitted into our hospital from January 2012 to December 2014 were selected.According to born within 1 min after the neonatal Apgar score，42 cases as severe asphyxia group and 81 cases as mild asphyxia group.30 cases of healthy and without asphyxia newborn baby at the same period in our hospital were selected as control group.Three groups were phlebotomized within 24h after birth to determine serum hs-CRP and myocardial enzyme(AST，LDH，CK，CK-MB，α-HBDH) for comparative analysis. Results The hs-CRP and myocardial enzyme in the severe asphyxia group were higher than those in the mild asphyxia group，the difference was statistically significant(P<0.05).The hs-CRP and myocardial enzyme in the mild asphyxia group were higher than those in the control group，the difference was statistically significant(P<0.05). Conclusion Both hs-CRP and myocardial enzyme were increased in asphyxial newborns.The degrees of elevation are positively correlated with the degrees of asphyxia，which can be used as the indexes of evaluating myocardial damage and its severity.The determination of hs-CRP and myocardial enzyme has an important clinical value in the early diagnosis and prognostic evaluation on the myocardial damage caused by neonatal asphyxia.
[Key words] High sensitivity C-reactive protein；Myocardial enzyme；Neonatal asphyxia
新生儿窒息是指婴儿出生时无呼吸或呼吸抑制导致低氧血症及混和性酸中毒从而出现的临床症候群，是新生儿常见的危急重症，也是新生儿至残及死亡的主要原因之一。窒息所致的缺血缺氧引起低氧血症、高碳酸血症和酸中毒等病理变化，可致脑、心、肾、肝、胃肠道等多器官发生不同程度的损害，特别是心脏受损较为常见。窒息所至的新生儿早期心肌受损在临床无明显的特异性表现，尤其是轻度窒息患儿，一般情况下早期常无明显异常，容易造成漏诊、误诊，因此，为了对窒息新生儿的心肌损害做出早期诊断，以便及时采取有针对性的干预和治疗，使患儿得到最大程度康复，防止并发症的发生，本研究对123例窒息新生儿的血清超敏C-反应蛋白(hs-CRP)和心肌酶浓度进行检测，以探讨其与新生儿窒息程度的关系，为早期诊断和早期治疗新生儿窒息引起的心肌损伤提供理论依据。, http://www.100md.com(徐建民 周丽银 湛国豪)