Awada H, Al-Tannir M, Ziade M F, Alameh J, El Rajab M
Department of Pediatrics, Makassed General Hospital, Beirut, Lebanon.
Neonatology. 2007;92(2):105-10. doi: 10.1159/000100964. Epub 2007 Mar 21.
Cardiac troponin T (cTnT) has been proposed as specific biochemical marker for myocardial infarction in adults. Cardiac function in neonates could be influenced by the severity of respiratory distress and its ventilatory management.
To establish a normal range of cTnT in healthy neonates, compare troponin concentrations among healthy neonates and those in respiratory distress (sick) and detect whether any correlation occurs between severity of respiratory distress and troponin concentrations.
Concentrations of cTnT were compared between sick and healthy infants, accounting for confounding variables in a prospective investigation manner. Age at sampling, need for ventilation, duration of respiratory support, and inotropic use in addition to neonatal and maternal characteristics were assessed.
Samples were collected from 164 neonates (116 healthy and 48 sick). The medians [interquartile ranges] of cTnT in healthy and sick infants were 0.044 [0.027-0.073]mug/l and 0.121 [0.065-0.238] microg/l, respectively, with p < 0.0001. The 99th percentile for healthy neonates was 0.244 microg/l. Comparing both groups, there were significant differences concerning gestation, birth weight, Apgar at 5 min and admission to neonatal intensive care unit. Troponin concentrations in subgroups of sick infants including hypotensive, ventilated and dead infants were higher than other infants of the same subgroup. CTnT was positively correlated to the duration of respiratory support in ventilated neonates.
CTnT may prove to be a useful early marker for cardiac and respiratory dysfunction in newborns.
心肌肌钙蛋白T（cTnT）已被提议作为成人心肌梗死的特异性生化标志物。新生儿的心脏功能可能会受到呼吸窘迫严重程度及其通气管理的影响。
建立健康新生儿cTnT的正常范围，比较健康新生儿与呼吸窘迫（患病）新生儿的肌钙蛋白浓度，并检测呼吸窘迫严重程度与肌钙蛋白浓度之间是否存在相关性。
以前瞻性调查的方式比较患病婴儿和健康婴儿的cTnT浓度，同时考虑混杂变量。评估采样时的年龄、通气需求、呼吸支持持续时间、是否使用正性肌力药物以及新生儿和母亲的特征。
从164名新生儿（116名健康新生儿和48名患病新生儿）中采集样本。健康婴儿和患病婴儿的cTnT中位数[四分位间距]分别为0.044[0.027 - 0.073]μg/l和0.121[0.065 - 0.238]μg/l，p < 0.0001。健康新生儿的第99百分位数为0.244μg/l。比较两组，在孕周、出生体重、5分钟阿氏评分和入住新生儿重症监护病房方面存在显著差异。患病婴儿亚组（包括低血压、接受通气和死亡的婴儿）的肌钙蛋白浓度高于同一亚组的其他婴儿。在接受通气的新生儿中，CTnT与呼吸支持持续时间呈正相关。
CTnT可能被证明是新生儿心脏和呼吸功能障碍的有用早期标志物。
