早产窒息新生儿同型半胱氨酸联合心肌酶测定的临床价值

摘要

目的：探讨同型半胱氨酸（Hcy）联合心肌酶谱检测在早产窒息新生儿中的临床价值，为临床鉴别诊断及治疗早产患儿提供科学依据。方法选取2011年1月至2014年5月在该院住院的早产新生儿高胆红素血症患儿150例，并分为轻度窒息组和重度窒息组，同时选取新生儿生理性黄疸患儿100例设为对照组，分别检测血清总胆红素（TBIL ）、同型半胱氨酸（Hcy ）及心肌酶谱各指标水平，并进行比较分析。结果轻度窒息组及重度窒息组患儿Hcy、TBIL及各项心肌酶谱指标水平均高于对照组，差异均有统计学意义（P＜0．05）。结合临床资料及彩色多普勒超声检测结果，早产窒息高胆红素血症患儿中有3例诊断为心肌炎，29例诊断为亚临床心肌炎，46例诊断为疑似心肌炎。结论早产高胆红素血症患儿心肌细胞存在不同程度损伤，常规测定H cy及心肌酶谱对临床诊断新生儿心肌炎及亚临床心肌炎有积极意义。%Objective To explore the clinical significance of combined detection of homocysteine (Hcy) and myocardial enzyme spectrum in premature infants with asphyxia ,and provide scientific basis for differential diagnosis and treatment of hyperbilirubi‐nemia in premature infants .Methods A total of 150 cases of premature infants with hyperbilirubinemia hospitalized in this hospital from January 2011 to May 2014 were selected and divided into the mild asphyxia group and server asphyxia group .Other 100 cases of premature infants with physiologic jaundice were selected as the control group .Serum levels of total bilirubin(TBIL) ,homocys‐teine(Hcy) and indicators of myocardial enzyme spectrum were detected and comparatively analysed .Results The levels of TBIL , Hcy and indicators of myocardial enzyme spectrum in the mild asphyxia group and server asphyxia group were higher than those in the control group ,had statistically significant differences(P<0 .05) .Combined with the clinical data and the detection results of col‐or Doppler ultrasound ,3 cases of premature infants with asphyxia complicated with hyperbilirubinemia were diagnosed as myocardi‐tis ,29 cases were diagnosed as subclinical myocarditis and 46 cases were diagnosed as suspected myocarditis .Conclusion Different degrees of myocardial cell damage exists in premature infants with hyperbilirubinemia ,and routine determination of Hcy and myo‐cardial enzyme spectrum have positive significance for clinical diagnosis of neonatal myocarditis and subclinical myocarditis .