本文選題：新生兒窒息 + 心肌損傷　； 參考：《重慶醫(yī)學(xué)》2017年31期

【摘要】：目的觀察血清肌酸激酶同工酶(CK-MB)、心肌鈣蛋白T(cTnT)水平對(duì)新生兒窒息后心肌損傷及治療效果的預(yù)測(cè)價(jià)值。方法選取2015年6月至2016年6月成都市第五人民醫(yī)院收治的足月新生兒窒息(NA)患兒541例和237例無(wú)窒息足月新生兒進(jìn)行研究,根據(jù)NA標(biāo)準(zhǔn)將患兒分為健康對(duì)照組(無(wú)NA足月新生兒)237例、非心肌損傷組(符合窒息診斷標(biāo)準(zhǔn)無(wú)心肌損傷)315例和心肌損傷組(符合窒息診斷標(biāo)準(zhǔn)有心肌損傷)226例。于出生后24h內(nèi)抽取受試者外周靜脈血2mL,檢測(cè)血清CKMB和cTnT水平,心肌損傷組采用常規(guī)治療方法治療7d后評(píng)定療效,觀察CK-MB、cTnT水平對(duì)NA后心肌損傷和治療效果的預(yù)測(cè)價(jià)值。結(jié)果組間CK-MB和cTnT水平比較,差異有統(tǒng)計(jì)學(xué)意義(P0.01),心肌損傷組水平高于其余兩組(P0.05),非心肌損傷組高于健康對(duì)照組(P0.05)。以CK-MB≥24U/L和cTnT≥100pg/mL為參考標(biāo)準(zhǔn)診斷NA后心肌損傷,結(jié)果顯示,CK-MB診斷NA后心肌損傷的曲線下面積(AUC)低于cTnT(P0.01)。CK-MB預(yù)測(cè)治療無(wú)效的靈敏度為72.00%,特異度為76.12%,符合度為75.66%,最佳截?cái)嘀禐?19.3 U/L,AUC為0.741;cTnT預(yù)測(cè)治療無(wú)效的靈敏度為80.00%,特異度為90.55%,符合度為89.38%,最佳截?cái)嘀禐?64.1pg/mL,AUC為0.853,兩組AUC比較差異有統(tǒng)計(jì)學(xué)意義(Z=3.695,P0.01)。結(jié)論 CK-MB和cTnT可作為診斷NA后心肌損傷和預(yù)測(cè)治療效果的生化指標(biāo),cTnT診斷價(jià)值和預(yù)測(cè)價(jià)值均優(yōu)于CKMB,值得臨床推廣應(yīng)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，

本文編號(hào)：1811016