临床儿科杂志
臨床兒科雜誌
림상인과잡지
2010年
3期
226-230
,共5页
毛庆花%林丽星%张志玲%安彩霞%康曦光
毛慶花%林麗星%張誌玲%安綵霞%康晞光
모경화%림려성%장지령%안채하%강희광
新生儿%窒息%心肌损伤%糖原磷酸化酶同功酶脑型
新生兒%窒息%心肌損傷%糖原燐痠化酶同功酶腦型
신생인%질식%심기손상%당원린산화매동공매뇌형
neonates%asphyxia%myocardial injury%glycogen phosphonylase isoenzyme BB
目的 探讨糖原磷酸化酶同功酶脑型(glycogen phosphorylase isoenzyme BB,GPBB)在新生儿窒息合并心肌损伤中的变化及与各种围生因素的相关性.方法 随机选择64例窒息患儿为研究对象(轻度窒息39例,重度窒息25例;心肌损伤30例,非心肌损伤34例),以25例正常新生儿为对照组.采用酶联免疫吸附法(ELISA)测定血浆GPBB水平,同时检测心肌酶、肌钙蛋白I、心电图、X线胸片等.结果 心肌损伤患儿血浆GPBB(13.84,7.57 ng/ml)明显高于非心肌损伤组(4.97,3.24 ng/ml)和对照组(4.95,1.99 ng/ml)(P ＜ 0.01).GPBB、cTnI、CK-MB诊断心肌损伤的敏感性分别为90%、66.7%、83.3%,GPBB的敏感性优于cTnI(χ~2 ＝ 4.812,P ＜ 0.05),与CK-MB比较差异无统计学意义(χ~2 ＝ 0.577,P ＞ 0.05);GPBB、cTnI、CK-MB诊断心肌损伤的特异性分别为88.2%、91.2%、67.6%,GPBB的特异性优于CK-MB(χ~2 ＝ 4.191,P ＜ 0.05),与cTnI比较差异无统计学意义(χ~2 ＝ 0.159,P ＞ 0.05).重度窒息组血浆GPBB水平(14.67,6.09 ng/ml)与轻度窒息组(5.61,3.56 ng/ml)和对照组比较均显著升高(P ＜ 0.01);轻度窒息组GPBB水平与对照组比较略升高,但差异无统计学意义(P ＞ 0.05).血浆GPBB水平与羊水污染程度呈正相关(r ＝ 0.500,P ＜ 0.001);与Apgar评分呈负相关(r ＝ -0.520,P ＜ 0.001).结论 GPBB可作为窒息新生儿早期诊断心肌缺血损伤的理想标志物,对窒息儿早期测定GPBB有助于判断新生儿有无心肌损伤及损害程度.
目的 探討糖原燐痠化酶同功酶腦型(glycogen phosphorylase isoenzyme BB,GPBB)在新生兒窒息閤併心肌損傷中的變化及與各種圍生因素的相關性.方法 隨機選擇64例窒息患兒為研究對象(輕度窒息39例,重度窒息25例;心肌損傷30例,非心肌損傷34例),以25例正常新生兒為對照組.採用酶聯免疫吸附法(ELISA)測定血漿GPBB水平,同時檢測心肌酶、肌鈣蛋白I、心電圖、X線胸片等.結果 心肌損傷患兒血漿GPBB(13.84,7.57 ng/ml)明顯高于非心肌損傷組(4.97,3.24 ng/ml)和對照組(4.95,1.99 ng/ml)(P ＜ 0.01).GPBB、cTnI、CK-MB診斷心肌損傷的敏感性分彆為90%、66.7%、83.3%,GPBB的敏感性優于cTnI(χ~2 ＝ 4.812,P ＜ 0.05),與CK-MB比較差異無統計學意義(χ~2 ＝ 0.577,P ＞ 0.05);GPBB、cTnI、CK-MB診斷心肌損傷的特異性分彆為88.2%、91.2%、67.6%,GPBB的特異性優于CK-MB(χ~2 ＝ 4.191,P ＜ 0.05),與cTnI比較差異無統計學意義(χ~2 ＝ 0.159,P ＞ 0.05).重度窒息組血漿GPBB水平(14.67,6.09 ng/ml)與輕度窒息組(5.61,3.56 ng/ml)和對照組比較均顯著升高(P ＜ 0.01);輕度窒息組GPBB水平與對照組比較略升高,但差異無統計學意義(P ＞ 0.05).血漿GPBB水平與羊水汙染程度呈正相關(r ＝ 0.500,P ＜ 0.001);與Apgar評分呈負相關(r ＝ -0.520,P ＜ 0.001).結論 GPBB可作為窒息新生兒早期診斷心肌缺血損傷的理想標誌物,對窒息兒早期測定GPBB有助于判斷新生兒有無心肌損傷及損害程度.
목적 탐토당원린산화매동공매뇌형(glycogen phosphorylase isoenzyme BB,GPBB)재신생인질식합병심기손상중적변화급여각충위생인소적상관성.방법 수궤선택64례질식환인위연구대상(경도질식39례,중도질식25례;심기손상30례,비심기손상34례),이25례정상신생인위대조조.채용매련면역흡부법(ELISA)측정혈장GPBB수평,동시검측심기매、기개단백I、심전도、X선흉편등.결과 심기손상환인혈장GPBB(13.84,7.57 ng/ml)명현고우비심기손상조(4.97,3.24 ng/ml)화대조조(4.95,1.99 ng/ml)(P ＜ 0.01).GPBB、cTnI、CK-MB진단심기손상적민감성분별위90%、66.7%、83.3%,GPBB적민감성우우cTnI(χ~2 ＝ 4.812,P ＜ 0.05),여CK-MB비교차이무통계학의의(χ~2 ＝ 0.577,P ＞ 0.05);GPBB、cTnI、CK-MB진단심기손상적특이성분별위88.2%、91.2%、67.6%,GPBB적특이성우우CK-MB(χ~2 ＝ 4.191,P ＜ 0.05),여cTnI비교차이무통계학의의(χ~2 ＝ 0.159,P ＞ 0.05).중도질식조혈장GPBB수평(14.67,6.09 ng/ml)여경도질식조(5.61,3.56 ng/ml)화대조조비교균현저승고(P ＜ 0.01);경도질식조GPBB수평여대조조비교략승고,단차이무통계학의의(P ＞ 0.05).혈장GPBB수평여양수오염정도정정상관(r ＝ 0.500,P ＜ 0.001);여Apgar평분정부상관(r ＝ -0.520,P ＜ 0.001).결론 GPBB가작위질식신생인조기진단심기결혈손상적이상표지물,대질식인조기측정GPBB유조우판단신생인유무심기손상급손해정도.
Objective To study the change of glycogen phosphorylase isoenzyme BB(GPBB)in neonates with asphyxia complicated with myocardial injury and its correlation with various perinatal factors. Methods Sixty-four neonates with asphyxia(including 39 mild asphyxia and 25 severe asphyxiated neonates,30 neonates with and 34 without myocardial injures)were enrolled and 25 healthy neonates were studied as control. The plasma levels of GPBB were measured by enzyme-linked immunosorbent assay(ELISA). Myocardial enzymes,cardiac troponin I,electrocardiogram,chest X-ray were performed simultaneously. Results The plasma GPBB levels were significantly higher in neonates with myocardial injury(13.84,7.57 ng/ml)than those without myocardial injury(4.97,3.24 ng/ml)and control group(4.95,1.99 ng/ml)( P ＜ 0.01). The sensitivities of GPBB,cTnI and CK-MB in diagnosing myocardial injury were 90%,66.7% and 83.3%,respectively. The sensitivity of GPBB was significantly higher than that of cTnI(χ~2 ＝ 4.812,P ＜ 0.05),with no statistical difference between GPBB and CK-MB(χ~2 ＝ 0.577,P ＞ 0.05). The specificities of GPBB,cTnI and CK-MB in diagnosing myocardial injury were 88.2%,91.2% and 67.6%,respectively. The specificity of GPBB was significantly higher than that of CK-MB(χ~2 ＝ 4.191,P ＜ 0.05),with no statistical difference between GPBB and cTnI(χ~2 ＝ 0.159,P ＞ 0.05). Plasma GPBB levels were significantly higher in neonates with severe asphyxia(14.67,6.09 ng/ml)than those with mild asphyxia(5.61,3.56 ng/ml)and control group(P ＜ 0.01). GPBB levels were higher in mildly asphyxiated neonates than those in control neonates,but with no statistical significance(P ＞ 0.05). Spearman rank correlation analysis showed that plasma GPBB levels positively correlated with the cloudiness of the amniotic fluid(r ＝ 0.500,P ＜ 0.001)and negatively correlated with Apgar score(r ＝ -0.520,P ＜ 0.001). Conclusions This study indicated that GPBB can be used as an ideal biomarker of myocardial ischemia injury in neonates with asphyxia. The determination of GPBB in early neonatal period is useful in detecting and assessing the severity of myocardial injury.
