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窒息新生儿心肌酶谱与血钙水平的相关性分析

作者:未知

  [摘要] 目的 探讨窒息新生儿心肌酶谱与血钙水平的相关性,为新生儿窒息及继发心肌损伤的临床诊治提供参考。方法 便利选取2016年6月—2019年5月该院儿科收治的70例新生儿为研究对象,依据出生Apgar评分不同将入选新生儿分为实验组(窒息新生儿,35例)和对照组(无窒息新生儿,35例),抽取两组静脉血样测定血清Ca与心肌酶谱AST、CK与LDH水平值,比较观察指标差异,线性回顾Ca与心肌酶谱指标相关性。结果 实验组血清总钙(2.04±0.76)mmol/L,AST(94.16±32.37)U/L,CK(1 273.8±411.93)U/L, LDH(841.7±376.8)U/L,与对照组差异有统计学意义(t=3.116,5.291,16.552,12.681;P<0.05);线性分析窒息新生儿血清Ca与心肌酶谱五项呈显著负相关(r=-0.875,-0.911,-0.902;P<0.05)。结论 窒息新生儿血清钙与心肌酶谱存在异常改变,且窒息越严重,血清钙水平越低,心肌酶谱指标越高,两者呈显著负相关,联合监测对患者病情诊断、治疗及预后评估具有参考价值,值得临床推广。
  [关键词] 新生儿;窒息;心肌酶谱;血清总钙;相关性
  [中图分类号] R722          [文献标识码] A          [文章编号] 1674-0742(2019)12(a)-0060-03
  [Abstract] Objective To investigate the correlation between Myocardial Zymogram and serum calcium level in asphyxiated neonates, and to provide reference for clinical diagnosis and treatment of asphyxia neonatorum and secondary myocardial injury. Methods Convenient elected 70 neonates admitted to the hospital from June 2016 to May 2019 were divided into experimental group (35 asphyxiated neonates) and control group (35 non-asphyxiated neonates) according to the birth Apgar score. The levels of serum Ca and AST, CK and LDH of myocardial zymogram were measured with venous blood samples from two groups. The differences of the indexes were compared and the correlation between Ca and myocardial zymogram was linearly reviewed. Results The experimental group had serum total calcium (2.04±0.76) mmol/L, AST (94.16±32.37) U/L, CK (1273.8±411.93) U/L, LDH(841.7±376.8) U/L, and the control group had statistics. Differences(t=3.116, 5.291, 16.552, 12.681; P<0.05); linear analysis of neonatal serum Ca was significantly negatively correlated with myocardial zymogram (r=-0.875, -0.911, -0.902; P<0.05). Conclusion Neonatal serum calcium and myocardial zymogram abnormal changes, the more severe the asphyxia, the lower the serum calcium level, the higher the myocardial zymogram index, the two showed a significant negative correlation, joint monitoring for the patient's disease diagnosis, treatment and prognosis evaluation Value is worthy of clinical promotion.
  [Key words] Neonates; Asphyxia; Myocardial zymogram; Serum total calcium; Correlation
  窒息指人體呼吸受阻或异常导致器官组织缺氧及继发细胞代谢障碍、功能紊乱的病理状态[1]。新生儿时期,围产期多因素常导致胎儿宫内窘迫或娩出后早期未能建立有效呼吸,故窒息发生率较高,可引起多脏器功能损害,特别是心脑并发症,对患儿预后影响明显,重者可引起死亡,应引起临床高度重视,加强早期防治[2]。低钙血症是新生儿窒息常见症状,与缺血缺氧引起电解质紊乱有关,而缺血缺氧也十分容易引起新生儿心肌损伤,表现为心肌酶谱高度异常[3]。文章现便利择取2016年6月—2019年5月该院70例新生儿,分析探讨血钙与心肌酶谱水平在窒息新生儿中的相关性,以更好地指导临床观察及治疗,现报道如下。   [5]  李丽珍,陈成彩,梁燕玲, 等.二维斑点追踪成像技术在诊断新生儿窒息心肌损害中的应用及其与血清肌钙蛋白的相关性分析[J].河北医学,2018,24(5):876-880.
  [6]  高创.磷酸肌酸辅助治疗新生儿窒息合并重度心肌损害的效果及对CK-MB、LDH、HBDH的影响[J].中外医学研究,2018,16(34):143-144.
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  [11]  戚文斌.心肌酶谱在新生儿窒息心肌损害上的临床治疗体会探究[J].中外女性健康研究,2017(19):60,63.
  [12]  黄青兰.肌酸激酶同工酶和肌钙蛋白T检测在窒息导致新生儿心肌损害中的临床应用价值[J].临床合理用药杂志,2018,11(19):156-157.
  (收稿日期:2019-09-04)
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