新生儿病理性黄疸高敏心肌肌钙蛋白T检测及分析

摘要

Objective To investigate primarily the differences of serum high-sensitivity cardiac troponin-T ( hs-cTnT) in healthy children in different periods and the changes of hs-cTnT in neonates with pathological jaundice,and compare it with creatine kinase MB ( CK-MB) and serum total bilirubin ( TBil). Methods The reference range of serum hs-cTnT in children was determined from 225 healthy children in age from 1 d to 6 years. The levels of hs-cTnT, CK-MB,TBil and direct bilirubin (DBil) were determined and compared between 46 neonates with pathological jaundice and 30 control neonates. The hs-cTnT levels were also compared with those of 31 neonates with preterm delivery,43 neonates with hypoxia and 12 neonates with infections. Results The reference interval of hs-cTnT was 0-0. 074 μg/L. The level of serum hs-cTnT in healthy children decreased with the increasing of age and reached the adult's level at 6 months after birth. The average level of hs-cTnT in 46 neonates with pathological jaundice was(0. 120 ±0. 095) μg/L, and was significantly higher than those in the control group[ (0. 035 ±0. 020) μg/L] ,preterm delivery group [ (0. 065 ± 0.035) μ/L], infection group [(0.037 ±0.017) μg/L] and hypoxia group [ (0. 051 ±0. 026) μg/L] (P <0. 001) . The levels of TBil, DBil and CK-MB in neonates with pathological jaundice were also significantly higher than those in the control group (P < 0. 000 1 and P <0.05). There was no significant correlation between hs-cTnT and TBil in neonates with pathological jaundice ( r = 0. 088 6, P > 0. 05 ). Conclusions In healthy children, the level of serum hs-cTnT decreases with the increasing of age and reaches the adult's level at 6 months after birth. The level of serum hs-cTnT can be used to indicate the myocardial injury in neonates with pathological jaundice and provide the reference for the early diagnosis, laboratory examination and following therapy in neonates with pathological jaundice.%目的 初步探讨不同时期健康儿童血清高敏心肌肌钙蛋白T(hs-cTnT)的差异,分析hs-cTnT在新生儿病理性黄疸中的变化及其与肌酸激酶同工酶(CK-MB)、血清总胆红素(TBil)水平的比较.方法 分组检测225名出生1d～6岁健康儿童hs-cTnT参考区间；检测46例新生儿病理性黄疸患儿和30名新生儿对照组hs-cTnT、CK-MB、TBil及直接胆红素(DBil)水平,并与31例早产儿、43例新生儿缺氧性疾病患儿、12例新生儿感染患儿hs-cTnT进行比较.结果 新生儿血清hs-cTnT参考区间为0～0.074μg/L.健康儿童血清hs-cTnT随年龄增长而降低,至6个月后接近成年人水平.46例新生儿病理性黄疸患儿hs-cTnT为(0.120±0.095) μg/L,明显高于对照组[(0.035±0.020) μg/L]、早产组[(0.065±0.035)μg/L]、新生儿感染组[(0.037±0.017) μg/L]和新生儿缺氧性疾病组[(0.051±0.026)μg/L](P均＜0.001).新生儿病理性黄疸患儿TBil、DBil及CK-MB亦明显高于对照组(P ＜0.000 l、P＜0.05).黄疸组hs-cTnT与TBil无相关性(r=0.088 6,P＞0.05).结论 健康儿童血清hs-cTnT随年龄增长而降低,至6个月后接近成年人水平.血清hs-cTnT可发现新生儿病理性黄疸患儿的心肌损伤并为临床早期诊断和采取进一步检查、治疗提供实验依据.