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目的探讨不同程度新生儿窒息后心肌酶谱的变化及其临床意义。方法将轻度窒息和重度窒息组新生儿按照治疗与否分成治疗组和非治疗组,治疗组给予1,6-二磷酸果糖营养心肌治疗,同时选择正常新生儿作为对照组。各组新生儿均在入院时及生后3、7 d检测肌酸激酶(CK)、肌酸激酶同工酶(CK-MB)、乳酸脱氢酶(LDH)、α-羟丁脱酸氢酶(HBDH),进行对比分析。结果入院时重度窒息组与轻度窒息组和正常组比较、轻度窒息组与正常组比较心肌酶谱各指标明显升高(P均<0.05)。生后3 d重度窒息组与轻度窒息组和正常组比较、轻度窒息组与正常组比较心肌酶谱各指标仍明显升高(P均<0.05)。生后7 d重度窒息组与轻度窒息组和正常组比较心肌酶谱各指标仍明显升高(P均<0.05),轻度窒息组与正常组比较各指标差异无统计学意义(P均>0.05)。治疗3 d后重度窒息组与轻度窒息组和正常组比较、轻度窒息组与正常组比较心肌酶谱各指标仍明显升高(P均<0.05)。治疗7 d后重度窒息组与轻度窒息组和正常组比较心肌酶谱各指标仍明显升高(P均<0.05),轻度窒息组与正常组比较各指标差异无统计学意义(P均>0.05)。生后3 d轻度窒息治疗组与未治疗组比较心肌酶谱各指标明显下降,重度窒息治疗组与未治疗组比较心肌酶谱各指标明显下降(P均<0.05);生后7 d轻度窒息治疗组与未治疗组比较心肌酶谱CK、HBDH差异有统计学意义(P均<0.05),CK-MB、LDH差异无统计学意义(P均>0.05),重度窒息治疗组与未治疗组比较心肌酶谱各指标明显下降(P均<0.05)。结论新生儿窒息可导致早期新生儿阶段心肌酶谱异常,1,6-二磷酸果糖治疗有助于改善心肌损害,应早期应用。
Objective To investigate the changes of myocardial enzymes and their clinical significance after neonatal asphyxia at different degrees. Methods Neonates with mild asphyxia and severe asphyxia were divided into treatment group and non-treatment group. The treatment group was given fructose 1,6-diphosphate nutrition cardiomyopathy, and the normal neonates were selected as the control group. Neonates in each group were tested for creatine kinase (CK), creatine kinase (CK-MB), lactate dehydrogenase (LDH), alpha-hydroxybutyrate Enzyme (HBDH), for comparative analysis. Results Compared with mild asphyxia group and normal group, the indexes of myocardial enzymes in mild asphyxia group and normal group were obviously increased (P <0.05). Compared with mild asphyxia group and normal group, the indexes of myocardial enzymes in mild asphyxia group and normal group were still significantly increased 3 days after birth (P <0.05). The indices of myocardial enzymes in severe asphyxia group were still significantly higher than those in mild asphyxia group and normal group on the 7th day after birth (all P <0.05), but there was no significant difference between mild asphyxia group and normal group (P < > 0.05). Compared with mild asphyxia group and normal group, the indexes of myocardial enzymes in mild asphyxia group and normal group were still significantly increased (P <0.05) after 3 days of treatment. After 7 days of treatment, the indexes of myocardial enzymes in severe asphyxia group were still significantly higher than those in mild asphyxia group and normal group (all P <0.05), but there was no significant difference between mild asphyxia group and normal group (P < > 0.05). Compared with the untreated group, the indexes of myocardial enzymes in the mild asphyxia group and the untreated group on 3 d after birth significantly decreased (P <0.05), and those in the severe asphyxia group and the untreated group decreased significantly There was significant difference in CK and HBDH between CKD group and untreated group (P <0.05), but CK-MB and LDH had no significant difference (P> 0.05), severe asphyxia group The indexes of myocardial enzymes in the treatment group were significantly decreased (all P <0.05). Conclusions Neonatal asphyxia can lead to abnormal myocardial enzymes in early neonatal stage. Fructose-1,6-diphosphate treatment can improve myocardial damage and should be applied early.