中国医师进修杂志
中國醫師進脩雜誌
중국의사진수잡지
CHINESE JOURNAL OF POSTGRADUATES OF MEDICINE
2013年
19期
32-34
,共3页
婴儿,新生%高胆红素血症%心肌损伤
嬰兒,新生%高膽紅素血癥%心肌損傷
영인,신생%고담홍소혈증%심기손상
Infant,newborn%Hyperbilirubinemia%Myocardial injury
目的 探讨高胆红素对心肌的损伤作用.方法 同时测定68例高胆红素血症新生儿(研究组)与38例生理性黄疸不明显的新生儿(对照组)治疗前后的血清总胆红素(TBIL)、肌酸激酶(CK)、肌酸激酶同工酶MB(CK-MB)、心肌肌钙蛋白Ⅰ(cTnI)的水平,并进行比较.结果 研究组治疗前血清TBIL、CK、CK-MB、cTnI水平显著高于对照组[(270.24±36.89)μmol/L比(68.95±10.87)μmol/L、(414.27±135.45) U/L比(178.35±59.62) U/L、(63.31±23.25) U/L比(16.78±8.89) U/L、(0.39±0.11) μg/L比(0.18±0.07) μgL],差异有统计学意义(P＜0.05).研究组治疗后血清TBIL、CK、CK-MB、cTnI水平明显降低[(69.13±9.98)μmol/L、(183.35±61.01) U/L、(17.45±9.08) U/L、(0.19±0.01)μg/L],与治疗前比较差异有统计学意义(P＜0.05),与对照组比较差异无统计学意义(P＞0.05).结论 高胆红素导致的心肌损伤具有可逆性.应常规对高胆红素血症新生儿的心肌酶谱与肌钙蛋白进行检测,以指导临床医生对心肌的保护性治疗.
目的 探討高膽紅素對心肌的損傷作用.方法 同時測定68例高膽紅素血癥新生兒(研究組)與38例生理性黃疸不明顯的新生兒(對照組)治療前後的血清總膽紅素(TBIL)、肌痠激酶(CK)、肌痠激酶同工酶MB(CK-MB)、心肌肌鈣蛋白Ⅰ(cTnI)的水平,併進行比較.結果 研究組治療前血清TBIL、CK、CK-MB、cTnI水平顯著高于對照組[(270.24±36.89)μmol/L比(68.95±10.87)μmol/L、(414.27±135.45) U/L比(178.35±59.62) U/L、(63.31±23.25) U/L比(16.78±8.89) U/L、(0.39±0.11) μg/L比(0.18±0.07) μgL],差異有統計學意義(P＜0.05).研究組治療後血清TBIL、CK、CK-MB、cTnI水平明顯降低[(69.13±9.98)μmol/L、(183.35±61.01) U/L、(17.45±9.08) U/L、(0.19±0.01)μg/L],與治療前比較差異有統計學意義(P＜0.05),與對照組比較差異無統計學意義(P＞0.05).結論 高膽紅素導緻的心肌損傷具有可逆性.應常規對高膽紅素血癥新生兒的心肌酶譜與肌鈣蛋白進行檢測,以指導臨床醫生對心肌的保護性治療.
목적 탐토고담홍소대심기적손상작용.방법 동시측정68례고담홍소혈증신생인(연구조)여38례생이성황달불명현적신생인(대조조)치료전후적혈청총담홍소(TBIL)、기산격매(CK)、기산격매동공매MB(CK-MB)、심기기개단백Ⅰ(cTnI)적수평,병진행비교.결과 연구조치료전혈청TBIL、CK、CK-MB、cTnI수평현저고우대조조[(270.24±36.89)μmol/L비(68.95±10.87)μmol/L、(414.27±135.45) U/L비(178.35±59.62) U/L、(63.31±23.25) U/L비(16.78±8.89) U/L、(0.39±0.11) μg/L비(0.18±0.07) μgL],차이유통계학의의(P＜0.05).연구조치료후혈청TBIL、CK、CK-MB、cTnI수평명현강저[(69.13±9.98)μmol/L、(183.35±61.01) U/L、(17.45±9.08) U/L、(0.19±0.01)μg/L],여치료전비교차이유통계학의의(P＜0.05),여대조조비교차이무통계학의의(P＞0.05).결론 고담홍소도치적심기손상구유가역성.응상규대고담홍소혈증신생인적심기매보여기개단백진행검측,이지도림상의생대심기적보호성치료.
Objective To explore the effect of high bilirubin on myocardial injury.Methods The levels of serum total bilirubin (TBIL),creatine kinase (CK),creatine kinase-isoenzyme MB(CK-MB),cardiac troponin Ⅰ (cTnI) were measured and compared in newborns without obvious physiological jaundice (control group) and newborns with hyperbilirubinemia (study group) before and after treatment.Results Compared with those in control group,the levels of serum TBIL,CK,CK-MB and cTnI in study group before treatment were obvious higher[(270.24 ± 36.89) μ mol/L vs.(68.95 ± 10.87) μ mol/L,(414.27 ± 135.45)U/L vs.(178.35 ± 59.62) U/L,(63.31 ± 23.25) U/L vs.(16.78 ± 8.89) U/L,(0.39 ± 0.11) μ g/L vs.(0.18 ± 0.07) μ g/L],and the differences between two groups were statistically significant (P ＜ 0.05).The levels of serum TBIL,CK,CK-MB and cTnI after treatment in study group [(69.13 ±9.98) μmol/L,(183.35 ± 61.01) U/L,(17.45 ± 9.0.8) U/L,(0.19 ± 0.01) μ g/L] were decreased obviously compared with those before treatment,and the differences between two groups were statistically significant (P ＜ 0.05).There was no significant difference between control group and study group after treatment (P ＞ 0.05).Conclusions High bilirubin can lead to a reversible myocardial injury.Cardiac enzymes and troponin testing should be routinely done for neonatal hyperbilirubinemia.It suggests doctors to attend to the treatment of myocardial protection.
