摘要
目的 探讨心肌酶谱检查对新生儿窒息后心肌损伤的诊断价值.方法 1.临床诊断:入选病例共102例,均为第1胎第1产,胎龄28442周,体重2500～4000g之间出生的足月新生儿,排除先天性心脏病,于生后2～24h取静脉血留血清标本,根据确定的诊断标准分为以下三组:①新生儿窒息并发心肌损伤组(C1)34例;②新生儿室息无心肌损伤组(NCI)38例;③正常对照组(NC)30例.2.实验方法:结果 :1.CI组五种心肌酶均显著高于Nc组和NCI组,NCI组除cK-MB外,其他四种酶也均显著高于NC组(P<0.05).2.以大于正常对照组95%单例上界为阳性结果,划定新生儿各心肌酶的正常上限值如下:AST 82u/1CK 595u/1,LDH 644u/1,2-IIBDH 735 u/1,CK-MB 39u/1超过此值为阳性结果.3.诊断价值评价显示:五种心肌酶对CI诊断的敏感性均为100%,但只有CK-MB有较好的特异性(96%)和准确度(970,).结沦:1.五种心肌酶对新生儿CI的确定均有一定的临床意义;2.诊断新生儿CI应确定新生儿各种心肌酶的正常正限值;3.CK-MB可作为新生儿CI的特异性诊断指标,有推广到基层医院的实用价值.
Objective In order to evaluate the diagnostic value of cardiomyonases in neonates with asphyxia complicating cardial injury.Methds 1.Clinical data:102 neonates with fun term and normal bilth weight,no congenital heart disease,were divided into three groups according to the diagnostis criteria.①neonatal asphyxia comphicatiny cardial mlury(CI)34 cases.②neonatal asphyxia no cardial injury(NCI) 38 cases.③normal control(NC)30 cases.The blood samples were taken from all the neonates at 2～24 hours after birth.2.Laboratory.Methods Five types serum cardiomyonases,Aspartate aminotransferase(AST),creatine kinase(CK),lactate dehydrogenase(LDH),2-hydroxybutyate dehydrogenase(2-HBDH),creating kinase isoenzyme MB(CK-MB),were measured by automatic bio-chemo-analyzer,usingthe enzymes-activated method.Result 1.All the cardiomyoncises in the CI group were significantly higher than those in NCI and NC groups(P<0.05).Apart from CK-MB,the other four types of cardiomyonases in NCI group were also significantly higher than those in NC group.2.The normal reference upper level in full term and normal birth weight neonates are:AST 82u/L,CK 595u/l LDH 644 u/L,2-HBDH,CK-MB 39 u/L,3 As cardial injury markers,an the five cardiomynases have good sensitivlty(100%),only the ck-mb also has better specificity(96%) and accuracy(97%).Conclusion 1.All the five cardiomyonases have some clinical meanings for diagnosis of cardial injury in neonates.2.horder to detect cardial injury in neonates,we should determine the normal reference upper level cardiomyonasis in the similar infants.3.CK-MB may be taken as a specific marker for diagnosis of cardial injury in neonates with asphyxia.It has practical value of extending to primary hospital.
出处
《医学检验与临床》
2008年第1期14-16,共3页
Medical Laboratory Science and Clinics
关键词
心肌酶
新生儿
窒息
心肌损伤
Cardiomyonases
Neonates
Asphyxia
Cardial injury
