Ho M L, Su P H, Chen J Y
Department of Pediatrics, Cheng Ching Hospital, Taichung, Taiwan.
Acta Paediatr Taiwan. 2000 May-Jun;41(3):129-32.
Estimations of serum enzyme values are widely employed as valuable diagnostic aids in diseases. Most commonly employed enzymes include Aspartate aminotransferase (AST), Lactate dehydrogenase (LDH), and Creatine kinase (CK). The study was designed to determine the relationship of elevated postnatal serum LDH, CK, and AST concentrations within the first day of life and the risk of suffering severe intraventricular hemorrhage (IVH) and/or periventricular leukomalacia (PVL) in VLBW preterm newborns. 81 preterm neonates whose birth body weight < 1500 gm were enrolled. Serums were obtained for measurement within the first postnatal day. Cranial ultrasound scans were performed twice per week after birth until their body weight was above 2300 gm or postconceptional age above 40 weeks. Significant difference was noted in serum LDH and CK concentrations in severe IVH/PVL infants (p < 0.05). No difference was found in serum AST values. Compared with the cut-off values of 1933 IU/L of LDH concentration and 652 IU/L of CK, the predictive values revealed a sensitivity, specificity, negative predictive value and positive predictive value of 76.9%, 89.7%, 95.3% and 58.8%, respectively. In conclusion, higher serum LDH and/or CK concentrations within the first day of life were associated with risk for development of severe IVH/PVL.
血清酶值的测定作为疾病诊断的重要辅助手段被广泛应用。最常用的酶包括天冬氨酸转氨酶(AST)、乳酸脱氢酶(LDH)和肌酸激酶(CK)。本研究旨在确定极低出生体重早产儿出生后第一天血清LDH、CK和AST浓度升高与发生严重脑室内出血(IVH)和/或脑室周围白质软化(PVL)风险之间的关系。纳入了81例出生体重<1500克的早产儿。在出生后第一天内采集血清进行检测。出生后每周进行两次头颅超声扫描,直至其体重超过2300克或孕龄超过40周。严重IVH/PVL婴儿的血清LDH和CK浓度有显著差异(p<0.05)。血清AST值无差异。与LDH浓度1933 IU/L和CK 652 IU/L的临界值相比,预测值显示敏感性、特异性、阴性预测值和阳性预测值分别为76.9%、89.7%、95.3%和58.8%。总之,出生后第一天血清LDH和/或CK浓度升高与严重IVH/PVL的发生风险相关。