新生兒窒息心肌損傷心肌酶和肌鈣蛋白T的改變及其臨床意義
本文選題:新生兒 切入點:窒息 出處:《廣西醫(yī)科大學(xué)》2012年碩士論文
【摘要】:目的:通過檢測血清肌酸激酶同工酶(CK-MB)、肌鈣蛋白T(cTnT),探討新生兒窒息時心肌損害情況及治療效果的評判指標(biāo),為及時給予心肌保護性治療,降低新生兒窒息的死亡率提供一定的參考。 方法:收集2010年12月至2011年12月期間廣西醫(yī)科大學(xué)第四附屬醫(yī)院兒科窒息新生兒60例,均符合新生兒窒息的診斷標(biāo)準(zhǔn),其中輕度窒息新生兒(輕度組)30例、重度窒息新生兒(重度組)30例,同時選擇健康新生兒(對照組)30例檢測CK-MB、cTnT的值作為對照,動態(tài)檢測輕度組、重度組治療前及治療后7天的CK-MB、cTnT的改變,對各組CK-MB、 cTnT值進行比較,探討窒息新生兒CK-MB和cTnT的變化以及作為病情轉(zhuǎn)歸評判指標(biāo)的臨床意義。采用方差分析及t/q檢驗比較的方法對各數(shù)據(jù)進行統(tǒng)計學(xué)分析。 結(jié)果:輕度組、重度組與對照組CK-MB、cTnT比較均明顯升高且差異有統(tǒng)計學(xué)意義(P0.05),重度組較輕度組CK-MB、cTnT亦有明顯升高且差異有統(tǒng)計學(xué)意義(P0.05);治療后輕度組、重度組CK-MB、cTnT均較治療前明顯下降,與治療前相比差異有統(tǒng)計學(xué)意義(P0.05),與對照組相比差異無統(tǒng)計學(xué)意義(P0.05) 結(jié)論:新生兒窒息時CK-MB、cTnT值均有不同程度的升高,其值的高低與窒息程度有關(guān);經(jīng)積極治療后7天,輕度組、重度組血清中CK-MB、 cTnT值均較治療前明顯下降;血清中CK-MB、cTnT作為窒息新生兒心肌損害的檢測指標(biāo)特異性強,能較好的指導(dǎo)兒科醫(yī)師在臨床診斷新生兒窒息時判斷早期有無并發(fā)心肌損傷、損傷程度、治療效果都有著一定的臨床意義。
[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.
【學(xué)位授予單位】:廣西醫(yī)科大學(xué)
【學(xué)位級別】:碩士
【學(xué)位授予年份】:2012
【分類號】:R722.1
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