肌钙蛋白在新生儿高胆红素血症的临床意义及在新生儿疾病中的应用

发布时间：2018-07-02 21:55

本文选题：心肌肌钙蛋白 + 新生儿　；参考：《天津医科大学》2017年硕士论文

【摘要】：目的:通过对新生儿高胆红素血症、新生儿感染性疾病及早产儿的心肌肌钙蛋白Ⅰ(cTnⅠ)的水平测定,以探讨心肌肌钙蛋白Ⅰ在新生儿中的临床意义。对象和方法:1.根据研究对象分类选取2015年1月至2016年8月期间天津医科大学宝坻临床学院新生儿科收治的180例新生儿作为研究对象,将上述新生儿分为足月高胆红素血症组、足月感染组、早产组三组,每组均为60例,选择同期住院的因腭裂或母亲为高龄产妇或母亲有不良妊娠史的足月新生儿60例为对照组,对照组患儿经住院观察为健康新生儿(腭裂患儿无其他并发症)。将上述新生儿均于住院当日或次日用干燥管留取静脉血3-4 m L送检,采用化学发光免疫分析法分别对4组患儿进行心肌肌钙蛋白Ⅰ检测,比较4组之间的差异并作对比分析。2.选取2015年1月至2016年8月期间天津医科大学宝坻临床学院收治的80例高胆红素血症新生儿(HBN)作为研究对象,根据HBN分型标准将其分为轻度HBN组40例、重度HBN组40例,取静脉血采用化学发光免疫分析法分别对2组患儿进行心肌肌钙蛋白Ⅰ检测,并采用全自动生化分析仪检测肝功能,指标包括谷丙转氨酶、总蛋白、白蛋白、总胆红素、间接胆红素等。3.选取2015年1月至2016年8月期间天津医科大学宝坻临床学院收治的80例高胆红素血症新生儿作为研究对象,根据是否溶血将其分为非溶血组40例、溶血组40例。取静脉血采用化学发光免疫分析法分别对2组患儿进行心肌肌钙蛋I检测,并采用全自动生化分析仪检测肝功能,指标包括谷丙转氨酶、总蛋白、白蛋白、总胆红素和间接胆红素。结果:1.足月高胆红素血症组、足月感染组、早产组新生儿与对照组新生儿在性别、日龄、分娩方式和Apgar评分无统计学差异(P0.05),而心肌肌钙蛋白Ⅰ检测水平高于对照组,差异有统计学意义(P〈0.05)。2.足月高胆红素血症组新生儿心肌肌钙蛋白Ⅰ检测水平高于足月感染组、早产组新生儿,差异有统计学意义(P〈0.05)。足月感染组、早产组两组新生儿心肌肌钙蛋白Ⅰ(cTnⅠ)检测水平差异无统计学意义(P0.05)。3.轻度高胆红素血症组与重度高胆红素血症组新生儿在性别、胎龄、日龄、分娩方式、羊水性质、出生体重、身长、头围和Apgar评分均无统计学差异(P0.05),两组新生儿心肌肌钙蛋白Ⅰ检测水平差异亦无统计学意义(P0.05),且总胆红素、间接胆红素与心肌肌钙蛋白无相关性。4.非溶血性高胆红素血症组与溶血性高胆红素血症组新生儿在性别、胎龄、日龄、分娩方式、羊水性质、出生体重、身长、头围和Apgar评分均无统计学差异(P0.05),两组新生儿心肌肌钙蛋I检测水平差异亦无统计学意义(P0.05)。结论:1.高胆红素血症、感染、早产等高危因素对新生儿心肌肌钙蛋白Ⅰ值的影响不同,其中高胆红素血症影响较大。2.高胆红素血症可引起心肌损害,但心肌肌钙蛋白Ⅰ不随胆红素水平的升高而升高。3.溶血与非溶血因素造成的高胆红素血症均影响心肌肌钙蛋白Ⅰ水平,但影响程度并无差异。
[Abstract]:Objective: To investigate the clinical significance of cardiac troponin I in newborn infants by measuring the level of neonatal hyperbilirubinemia, neonatal infectious diseases and premature infants' cardiac troponin I (cTn I). 1. according to the classification of the subjects from January 2015 to August 2016, the Baodi clinic of Medical University Of Tianjin was selected. 180 newborns treated in the new Department of pediatrics were divided into full term hyperbilirubinemia group, full term infection group and three group of premature delivery group, 60 cases in each group, and 60 full term newborns in the same period were selected as the control group because of cleft palate or mother or mother had a history of bad pregnancy. The hospitalized observation was healthy newborns (no other complications in children with cleft palate). All the newborns were left with 3-4 m L for venous blood on the day of hospitalization or daily use of dry tubes. The cardiac troponin I was detected by chemiluminescent immunoassay, and the differences between the 4 groups were compared and the comparison and analysis of the 4 groups were compared and analyzed in January 2015. 80 cases of hyperbilirubinemia (HBN) were treated in the Baodi Clinical College of Medical University Of Tianjin in August 2016 as the research object. According to the HBN classification standard, they were divided into 40 cases of mild HBN group and 40 cases of severe HBN group. The cardiac troponin I was detected by chemiluminescent immunoassay in 2 groups of children, and the use of chemiluminescence immunoassay was used to detect the cardiac troponin I. The automatic biochemical analyzer was used to detect liver function, including.3., total protein, albumin, total bilirubin, and indirect bilirubin in 80 cases of hyperbilirubinemia from January 2015 to August 2016 at the Baodi Clinical College of Medical University Of Tianjin, which were divided into non hemolytic group 40 according to whether hemolysis was hemolytic. 40 cases of hemolytic group were detected by chemiluminescence immunoassay in 2 groups. The I was detected in 2 groups of children, and the liver function was detected by automatic biochemical analyzer, including alanine aminotransferase, total protein, albumin, total bilirubin and indirect bilirubin. Fruit: 1. full term hyperbilirubinemia group, full term infection group, preterm delivery There was no statistical difference between the newborn and the control group in the sex, day of age, delivery mode and Apgar score (P0.05), but the detection level of cardiac troponin I was higher than that of the control group. The difference was statistically significant (P < 0.05) the detection level of cardiac muscle calcinin I in the neonates of.2. full term hyperbilirubinemia group was higher than that in the full term infection group. The difference was statistically significant (P < 0.05). There was no significant difference in the detection level of cardiac troponin I (cTn I) in the two groups of premature delivery group (P0.05) and there was no significant difference in the level of neonatal.3. mild hyperbilirubinemia group and severe hyperbilirubinemia group in sex, gestational age, age, mode of delivery, amniotic fluid, birth weight, body length, head circumference and There was no statistical difference in Apgar scores (P0.05). There was no significant difference between the two groups of neonatal cardiac troponin I detection (P0.05), and the total bilirubin, indirect bilirubin and cardiac troponin were not related to.4. non hemolytic hyperbilirubinemia group and hemolytic hyperbilinuremia group in the sex, gestational age, age, and childbirth. There was no statistical difference in the nature of amniotic fluid, birth weight, body length, head circumference and Apgar score (P0.05). There was no significant difference between the two groups of neonatal cardiac muscle calcium eggs (P0.05). Conclusion: the effects of high risk factors such as hyperbilirubinemia, infection, preterm birth and other high risk factors on neonatal cardiac troponin I value were different, in which hyperbilirubinemia was found. High.2. hyperbilirubinemia can cause myocardial damage, but cardiac troponin I does not increase with the increase of bilirubin level and the hyperbilirubinemia caused by.3. hemolysis and non hemolytic factors all affect the level of cardiac troponin I, but there is no difference in the degree of influence.
【学位授予单位】：天津医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R722.1

【参考文献】