Boo Nem-Yun, Hafidz Hasri, Nawawi Hapizah M, Cheah Fook-Choe, Fadzil Yong-Junina, Abdul-Aziz Bilkis B, Ismail Zulkifli
Department of Paediatrics, Hospital Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia.
J Paediatr Child Health. 2005 Jul;41(7):331-7. doi: 10.1111/j.1440-1754.2005.00626.x.
This prospective study aimed to compare serum creatine kinase MB isoenzyme (CK-MB) mass concentrations and cardiac troponin T (cTnT) concentrations during the first 48 h of life in asphyxiated term infants.
Serum cTnT and CK-MB mass concentrations of 50 term infants with clinical features of perinatal asphyxia were measured at birth and at 12, 24 and 48 h of age by chemiluminescence immunoassay. These infants were followed up until discharge or death. Cord blood CK-MB and cTnT concentrations of 50 healthy term infants were also assayed.
At birth, asphyxiated infants had significantly higher concentrations of cTnT and CK-MB than controls (P < 0.0001). Serum cTnT of asphyxiated infants with low ejection fraction <60% was significantly higher at 12 and 24 h than those with normal ejection fraction (P < 0.05). Asphyxiated infants with congestive cardiac failure had significantly higher serum cTnT concentration during the first 48 h of life than those without congestive cardiac failure (P <or= 0.04). Serum cTnT concentrations during the first 48 h of life were significantly higher in asphyxiated infants who died than those who survived (P < 0.0001). There was no significant difference in serum CK-MB mass concentrations between asphyxiated infants with and without these complications (P >or= 0.1).
Unlike CK-MB, serum cTnT concentrations are significantly higher in asphyxiated infants who die or develop cardiac dysfunction.
这项前瞻性研究旨在比较足月儿窒息后出生后48小时内血清肌酸激酶MB同工酶(CK-MB)质量浓度和心肌肌钙蛋白T(cTnT)浓度。
采用化学发光免疫分析法,对50例具有围产期窒息临床特征的足月儿在出生时、12小时、24小时和48小时测定血清cTnT和CK-MB质量浓度。对这些婴儿进行随访直至出院或死亡。同时检测50例健康足月儿脐血CK-MB和cTnT浓度。
出生时,窒息婴儿的cTnT和CK-MB浓度显著高于对照组(P<0.0001)。射血分数<60%的窒息婴儿在12小时和24小时时血清cTnT显著高于射血分数正常的婴儿(P<0.05)。患有充血性心力衰竭的窒息婴儿在出生后48小时内血清cTnT浓度显著高于无充血性心力衰竭的婴儿(P≤0.04)。死亡的窒息婴儿出生后48小时内血清cTnT浓度显著高于存活婴儿(P<0.0001)。有或无这些并发症的窒息婴儿血清CK-MB质量浓度无显著差异(P≥0.1)。
与CK-MB不同,死亡或发生心脏功能障碍的窒息婴儿血清cTnT浓度显著更高。