血清CK-MB、cTnT水平对新生儿窒息后心肌损伤及治疗效果的预测价值

发布时间：2018-04-27 13:58

  本文选题：新生儿窒息 + 心肌损伤　； 参考：《重庆医学》2017年31期

【摘要】：目的观察血清肌酸激酶同工酶(CK-MB)、心肌钙蛋白T(cTnT)水平对新生儿窒息后心肌损伤及治疗效果的预测价值。方法选取2015年6月至2016年6月成都市第五人民医院收治的足月新生儿窒息(NA)患儿541例和237例无窒息足月新生儿进行研究,根据NA标准将患儿分为健康对照组(无NA足月新生儿)237例、非心肌损伤组(符合窒息诊断标准无心肌损伤)315例和心肌损伤组(符合窒息诊断标准有心肌损伤)226例。于出生后24h内抽取受试者外周静脉血2mL,检测血清CKMB和cTnT水平,心肌损伤组采用常规治疗方法治疗7d后评定疗效,观察CK-MB、cTnT水平对NA后心肌损伤和治疗效果的预测价值。结果组间CK-MB和cTnT水平比较,差异有统计学意义(P0.01),心肌损伤组水平高于其余两组(P0.05),非心肌损伤组高于健康对照组(P0.05)。以CK-MB≥24U/L和cTnT≥100pg/mL为参考标准诊断NA后心肌损伤,结果显示,CK-MB诊断NA后心肌损伤的曲线下面积(AUC)低于cTnT(P0.01)。CK-MB预测治疗无效的灵敏度为72.00%,特异度为76.12%,符合度为75.66%,最佳截断值为119.3 U/L,AUC为0.741;cTnT预测治疗无效的灵敏度为80.00%,特异度为90.55%,符合度为89.38%,最佳截断值为264.1pg/mL,AUC为0.853,两组AUC比较差异有统计学意义(Z=3.695,P0.01)。结论 CK-MB和cTnT可作为诊断NA后心肌损伤和预测治疗效果的生化指标,cTnT诊断价值和预测价值均优于CKMB,值得临床推广应用。
[Abstract]:Objective to observe the predictive value of serum creatine kinase isoenzyme (CK-MBN) and cardiac troponin (TcTnT) on myocardial injury after asphyxia in neonates. Methods from June 2015 to June 2016, 541 cases of NAA and 237 cases of non-asphyxiated term neonates treated in Chengdu Fifth people's Hospital were studied. According to na criteria, the children were divided into healthy control group (237 cases without na term neonates), non-myocardial injury group (315 cases with no myocardial injury according to the diagnostic criteria of asphyxia) and myocardial injury group (226 cases with myocardial injury according to the criteria of asphyxia diagnosis). The peripheral venous blood (2mL) was taken from the subjects within 24 hours after birth to detect the levels of serum CKMB and cTnT. The therapeutic effect was evaluated after 7 days of routine treatment in the myocardial injury group. The predictive value of CK-MBN cTnT level on myocardial injury and therapeutic effect after na was observed. Results the levels of CK-MB and cTnT were significantly higher in the myocardial injury group than in the other two groups, and the level in the non-myocardial injury group was higher than that in the healthy control group. Myocardial injury after na was diagnosed by CK-MB 鈮，

本文编号：1811016