血清心肌酶水平在新生兒高膽紅素血癥診斷中的臨床意義

張茜 齊秀花 王明園

摘 要 目的：探討血清心肌酶水平在新生兒高膽紅素血癥診斷中的臨床意義。方法：選取新生兒高膽紅素血癥患兒92例作為研究組，依據(jù)總膽紅素（TBil）水平分為輕度組、中度組、重度組；選取同期健康新生兒30例為對(duì)照組。檢測(cè)血清心肌酶水平，比較不同病情程度患兒各項(xiàng)指標(biāo)的差異。結(jié)果：血清心肌酶水平比較，研究組高于對(duì)照組，重度組高于輕度組、中度組，且中度組各項(xiàng)指標(biāo)高于輕度組（P<0.05）。血清心肌酶水平與TBil水平呈正相關(guān)。結(jié)論：血清心肌酶在新生兒高膽紅素血癥中呈高表達(dá)，心肌酶譜指標(biāo)可診斷病情程度還能夠?qū)χ委熜ЧM(jìn)行評(píng)價(jià)。

關(guān)鍵詞 天冬氨酸氨基轉(zhuǎn)移酶 乳酸脫氫酶 肌酸激酶 羧丁酸脫氫酶 肌酸肌酶同功酶 新生兒高膽紅素血癥

中圖分類(lèi)號(hào)：R446.112； R722.17 文獻(xiàn)標(biāo)志碼：A 文章編號(hào)：1006-1533（2021）19-0035-04

The clinical significance of the serum myocardial enzyme level in the diagnosis of neonatal hyperbilirubinemia

ZHANG Qian， QI Xiuhua， WANG Mingyuan

（Department of Disease Control， the Seventh Peoples Hospital of Zhengzhou， Zhengzhou 450000， China）

ABSTRACT Objective： To explore the clinical significance of serum myocardial enzyme levels in the diagnosis of neonatal hyperbilirubinemia. Methods： Ninety-two neonates with hyperbilirubinemia were selected as a study group， which were divided into a mild subgroup， a moderate subgroup and a severe subgroup based on their total bilirubin （TBil） levels， and the other 30 healthy newborns were selected as a control group. Serum myocardial enzyme levels were determined and the differences in the indicators of children with different disease conditions were compared. Results： Serum myocardial enzyme levels were higher in the study group than the control group and in the severe subgroup than the mild group and the moderate group， and the indicators were higher in the moderate group than the mild group （P<0.05）. Serum myocardial enzyme levels were positively correlated with TBil levels. Conclusion： Serum myocardial enzyme is high-expressed in the children with neonatal hyperbilirubinemia. Myocardial zymogram can be used for the diagnosis of the degree of disease and the assessment of treatment effect.

KEy wORDS aspartate aminotransferase； lactate dehydrogenase； creatine kinase； carboxybutyrate dehydrogenase； creatine kinase isoenzyme； neonatal hyperbilirubinemia

新生兒高膽紅素血癥是指出生未滿28 d的新生兒黃疸，若未及時(shí)發(fā)現(xiàn)和治療，病情持續(xù)加重會(huì)損傷新生兒中樞神經(jīng)系統(tǒng)，繼發(fā)新生兒膽紅素腦病，造成運(yùn)動(dòng)、聽(tīng)力、認(rèn)知障礙，嚴(yán)重者甚至危及生命[1-2]。血清學(xué)檢測(cè)是診斷新生兒高膽紅素血癥及心肌損傷評(píng)估的重要依據(jù)，在以往的研究中，人們更多探究心肌酶指標(biāo)在新生兒高膽紅素血癥病情評(píng)估中的價(jià)值，但對(duì)于其療效評(píng)估中的價(jià)值研究較少[3]。

1 資料與方法

1.1 臨床資料

選取鄭州市第七人民醫(yī)院2016年6月—2019年3月收治的新生兒高膽紅素血癥患兒92例作為研究組，其中男性51例，女性41例；胎齡38～42周，平均胎齡（39.84±1.54）周；根據(jù)總膽紅素（total bilirubin， TBil）水平分為輕度組（TBil為205.0～259.9 μmol/L）31例，中度組（TBil為260.0～377.8 μmol/L）35例，重度組（TBil>377.8 μmol/L）26例。另選取同期健康新生兒30例作為對(duì)照組，其中男性18例，女性12例；胎齡38～42周，平均胎齡（39.71±1.47）周。兩組一般資料比較差異無(wú)統(tǒng)計(jì)學(xué)意義（P>0.05），具可比性。本研究經(jīng)醫(yī)院醫(yī)學(xué)倫理委員會(huì)的批準(zhǔn)。