摘要
目的探讨超声心动图检测肺动脉压力联合检测血清肌酸激酶同工酶(CK-MB)水平在新生儿缺氧缺血性脑病(HIE)患儿心肌损害中的诊断价值。方法选取右江民族医学院附属医院新生儿科2015年1月至2016年11月的住院患儿,经临床确诊的HIE患儿50例为研究组,依据2005年中华医学会儿科学分会新生儿学修订的HIE诊断与分度标准,将HIE组分为轻度组28例、中度组12组和重度组10例;选取非HIE患儿52例为对照组。检测并比较各组受检新生儿的心脏结构指标[左房前后径(LA)、左室前后径(LV)、右房左右径(RA)、右室前后径(RV)、主肺动脉内径(MPA)]、左室射血分数(LVEF)、肺动脉压力指标[肺动脉收缩压(PASP)、肺动脉舒张压(PADP)]及血清肌酸激酶同工酶(CK-MB)水平。结果研究组的心脏结构指标与对照组比较差异均有显著统计学意义(P<0.01);在心脏结构指标和LVEF方面,中度组与轻度组比较、重度组与中度组比较,差异均有显著统计学意义(P<0.01),而轻度组的LVEF测值与对照组比较差异无统计学意义(P>0.05);研究组患者的PASP、PADP及血清CK-MB值与对照组比较差异均有显著统计学意义(P<0.01);研究组患者入院治疗第1天与第3天PASP测值比较差异均无统计学意义(P>0.05),而入院治疗第1天与第7天、第3天与第7天PASP测值比较差异均有显著统计学意义(P<0.01);研究组患者入院治疗第1、3、7天三个时间点PADP、血清CK-MB值比较差异均有显著统计学意义(P<0.01);血清CK-MB与PASP和PADP均呈正相关(r=0.59、0.402,P<0.01)。结论 PASP、PADP联合血清CK-MB水平检测可提高HIE心肌损害的诊断价值,超声心动图操作安全、方便、可重复性高,值得推广。
Objective To explore the diagnostic value of combined detection of pulmonary artery pressure（by echocardiography） and serum creatine kinase isoenzyme（CK-MB） level in neonates with hypoxic-ischemic encephalopathy（HIE）. Methods A total of 50 children clinically diagnosed as HIE, who admitted to Department of Neonatology of the Affiliated Hospital of Youjiang Medical College for Nationalities from January 2015 to November 2016, were selected as the study group, which were divided into the mild HIE group（28 cases）, moderate HIE group（12 group） and severe HIE group（10 cases） according to the revised HIE diagnosis and grading criteria for Chinese Pediatric Society, Chinese Medical Association in 2005. A total of 52 non-HIE children were selected as the control group. The cardiac structural indexes（left atrial anteroposterior diameter [LA], left ventricular anteroposterior diameter [LV], right atrial left and right diameter [RA], right ventricular anteroposterior diameter [RV] and main pulmonary artery diameter [MPA]）, left ventricular ejection fraction（LVEF）, pulmonary arterial pressure indexes（pulmonary systolic pressure [PASP], pulmonary artery diastolic pressure [PADP]）, and serum creatine kinase isoenzyme（CK-MB） among the newborns in each group were detected and compared. Results There was a significant difference in the cardiac structural indexes between the study group and the control group（P〈0.01）. In the structural indexes and LVEF of the heart, there were statistically significant differences between the moderate HIE group and the mild HIE group, as well as between the severe HIE group and the moderate HIE group（P〈0.01）, with no significant difference between the control group and the mild HIE group in the LVEF value（P〉0.05）. There were significant differences in PASP, PADP and serum CK-MB between the study group and the control group（P〈0.01）. There was no significant difference in the value of PASP between first day and third day after admission
作者
李丽珍
黄君
梁燕玲
罗雪清
陈成彩
LI Li-zhen;HUANG Jun;LIANG Yah-ling;LUO Xue-qing;CHEN Cheng-cai(Department of Ultrasound, Youfiang Medical University for Nationalities, Baise 533000, Guangxi, CHINA;Department of Ultrasound, the First Affiliated Hospital of Jinan University, Guangzhou 510000, Guangdong, CHINA)
出处
《海南医学》
CAS
2018年第11期1543-1547,共5页
Hainan Medical Journal
基金
广西百色市科学研究与技术开发课题(编号:20171114)
关键词
超声心动图
肌酸激酶同工酶
新生儿
缺氧缺血性脑病
心肌损害
Encephalopathy
Creatine kinase isoenzyme （CK-MB）
Newborn
Hypoxic-ischemic encephalopathy
Myocardial damage
