摘要
目的通过临床上对新生儿感染性休克心肌肌钙蛋白Ⅰ(cTnI)及部分酶学在整个感染过程中的水平的变化,探讨cTnI在新生儿感染休克中的敏感性及特异性。方法将2010年1月～2012年2月我院收治的感染性休克新生儿84例作为研究对象,分别于患儿发病急性期6、24、48 h及恢复期7 d采集静脉血2 mL,联合检测cTnI、肌酸激酶(CK)、肌酸激酶同功酶(CK-MB)、乳酸脱氢酶(LDH)、C反应蛋白酶(CRP)含量,并描记心电图,进行新生儿危重病例评分(NCIS)。结果通过存活的40例新生儿发病各时期cTnI、CK、CK-MB、LDH、CRP水平变化,发现cTnI 6 h数值为(2.53±0.81)ng/mL,升高病例达84.6%,24h达高峰(5.42±1.74)ng/mL,升高病例达93.5%,48h下降至(3.16±0.91)ng/mL,7 d接近正常值(0.56±0.11)ng/mL,6 h与正常值、7 d对比,差异有高度统计学意义(P<0.01),24 h与6、48 h对比,差异有统计学意义(P<0.05),具有敏感性。并通过上述生化物质分别与各时段NCIS相关性分析,cTnI水平改变与NCIS改变呈正相关,可反映新生儿感染性休克的严重程度,具有特异性。结论当新生儿感染性休克时,其cTnI及其他部分酶学水平都会发生变化,采用cTnI评价新生儿感染性休克心肌损伤具有敏感性及特异性,且cTnI对新生儿感染性休克评估病情轻重及预后具有重要的临床意义。
Objective Through the change of cardiac troponin Ⅰ（cTnI） and part enzymology levels in the whole process of the infection on neonatal septic shock,and to explore sensitive and specific of cTnI.Methods 84 cases of septic shock newborn in our hospital were selected as research objects,in the acute phase of children were 6 h,24 h,48 h and recovery 7 d acquisition venous blood 2 mL,cTnI,creatine kinase（CK）,creatine kinase success enzyme（CK-MB）,lactate dehydrogenase（LDH）,C reaction protease（CRP） content,and electrocardiogram（ECG） was detected,and they were given a new serious disease score（NCIS）.Results Through the survival of the newborn period of 40 patients cTnI,CK,CK-MB,LDH, CRP level change,found that cTnI 6 h was（2.53 ±0.81）ng/mL,the rise of 84.6%,24 h peak of（5.42 ±1.74）ng/mL,the rise of 93.5%,48 h to decrease（3.16±0.91）ng/mL,7 d close to normal（0.56±0.11）ng/mL,6 h compared with normal,7 d,there was a significant difference（P0.01）,there was a significant difference between 24 h and 6 h,48 h（P0.05）,with sensitive.And through the biochemical substances respectively with each period NCIS correlation analysis,cTnI levels change and NCIS change was positive correlation,reflected the severity of the newborn septic shock,with specificity.Conclusion For neonatal septic shock,the myocardial cTnI and other part enzymology levels will change,cTnI evaluation on neonatal septic shock myocardial injuries has sensitive and specific,cTnI to neonatal septic shock assessment of the severity and prognosis has important clinical significance.
出处
《中国医药导报》
CAS
2012年第29期77-79,共3页
China Medical Herald
基金
广东省深圳市宝安区科技计划社会公益资助项目(20110574)
