新生儿窒息心肌损伤心肌酶和肌钙蛋白T的改变及其临床意义

发布时间：2018-03-31 01:09

本文选题：新生儿　切入点：窒息　出处：《广西医科大学》2012年硕士论文

【摘要】：目的：通过检测血清肌酸激酶同工酶(CK-MB)、肌钙蛋白T(cTnT),探讨新生儿窒息时心肌损害情况及治疗效果的评判指标,为及时给予心肌保护性治疗,降低新生儿窒息的死亡率提供一定的参考。方法：收集2010年12月至2011年12月期间广西医科大学第四附属医院儿科窒息新生儿60例,均符合新生儿窒息的诊断标准,其中轻度窒息新生儿(轻度组)30例、重度窒息新生儿(重度组)30例,同时选择健康新生儿(对照组)30例检测CK-MB、cTnT的值作为对照,动态检测轻度组、重度组治疗前及治疗后7天的CK-MB、cTnT的改变,对各组CK-MB、 cTnT值进行比较,探讨窒息新生儿CK-MB和cTnT的变化以及作为病情转归评判指标的临床意义。采用方差分析及t／q检验比较的方法对各数据进行统计学分析。结果：轻度组、重度组与对照组CK-MB、cTnT比较均明显升高且差异有统计学意义(P0.05),重度组较轻度组CK-MB、cTnT亦有明显升高且差异有统计学意义(P0.05)；治疗后轻度组、重度组CK-MB、cTnT均较治疗前明显下降,与治疗前相比差异有统计学意义(P0.05),与对照组相比差异无统计学意义(P0.05) 结论：新生儿窒息时CK-MB、cTnT值均有不同程度的升高,其值的高低与窒息程度有关;经积极治疗后7天,轻度组、重度组血清中CK-MB、 cTnT值均较治疗前明显下降；血清中CK-MB、cTnT作为窒息新生儿心肌损害的检测指标特异性强,能较好的指导儿科医师在临床诊断新生儿窒息时判断早期有无并发心肌损伤、损伤程度、治疗效果都有着一定的临床意义。
[Abstract]:Objective: to investigate the myocardial damage and therapeutic effect of neonatal asphyxia by detecting serum creatine kinase isoenzyme CK-MBP and troponin TnTnTnTX, so as to provide timely myocardial protective therapy. To reduce the death rate of neonatal asphyxia provides a certain reference. Methods: from December 2010 to December 2011, 60 neonates with asphyxia neonatorum in the fourth affiliated Hospital of Guangxi Medical University were collected. All of them met the diagnostic criteria of neonatal asphyxia, including 30 cases of mild asphyxia neonates (mild group). 30 cases of severe asphyxia neonates (severe group) and 30 cases of healthy newborns (control group 30 cases) were selected as control group. The changes of CK-MBcTnT in mild group, severe group before treatment and 7 days after treatment were detected dynamically. The CK-MBand cTnT values were compared in each group. To explore the changes of CK-MB and cTnT in asphyxia neonates and their clinical significance as indicators of prognosis, the statistical analysis of each data was carried out by means of variance analysis and t / Q test. Results: CK-MBN cTnT in mild group, severe group and control group were significantly higher than those in control group (P 0.05), and CK-MBN cTnT in severe group was significantly higher than that in mild group (P 0.05). The CK-MBN cTnT in severe group was significantly lower than that before treatment, and there was a significant difference between before treatment and before treatment (P 0.05), but there was no significant difference between severe group and control group (P 0.05). Conclusion: the levels of CK-MBN cTnT in neonates with asphyxia were increased in varying degrees, and the levels of CK-MBand cTnT were significantly decreased in mild and severe groups after 7 days of active treatment. Serum CK-MBN cTnT is a specific index for the detection of myocardial damage in asphyxia neonates, which can be used to guide pediatricians in the early diagnosis of neonatal asphyxia. The therapeutic effect has certain clinical significance.
【学位授予单位】：广西医科大学
【学位级别】：硕士
【学位授予年份】：2012
【分类号】：R722.1

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