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围产期窒息时的心电图和超声心动图变化。

Electrocardiographic and echocardiographic changes in perinatal asphyxia.

作者信息

Rajakumar P S, Vishnu Bhat B, Sridhar M G, Balachander J, Konar B C, Narayanan P, Chetan G

机构信息

Department of Pediatrics, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India.

出版信息

Indian J Pediatr. 2009 Mar;76(3):261-4. doi: 10.1007/s12098-008-0221-4. Epub 2008 Dec 4.

Abstract

OBJECTIVE

To study the usefulness of cardiac enzymes in evaluating myocardial damage in perinatal asphyxia.

METHODS

Thirty term babies with perinatal asphyxia and without any congenital malformations were selected as cases. They were compared with thirty healthy term babies without asphyxia. Myocardial dysfunction was evaluated using clinical, electrocardiography, echocardiography and cardiac enzymes i.e, troponin-T and CK-MB levels.

RESULTS

Among the 30 cases 23 had evidence of myocardial involvement while one baby in the control group had ECG evidence compatible with cardiac involvement. Cardiac enzymes were significantly increased in babies with perinatal asphyxia. The mean level of C-troponin-T among cases and controls were 0.22+/-0.28 and 0.003+/-0.018 while CK-MB levels were 121+/-77.4 IU/L and 28.8 +/- 20.2 IU/L respectively. C-troponin-T had higher sensitivity and specificity compared to CK-MB levels. Moreover, C troponin-T levels correlated well with severity and outcome in babies with perinatal asphyxia.

CONCLUSION

C-Tropopnin assay is useful in evaluating the severity of myocardial damage and outcome in perinatal asphyxia.

摘要

目的

研究心肌酶在评估围产期窒息心肌损伤中的作用。

方法

选取30例足月围产期窒息且无任何先天性畸形的婴儿作为病例组。将他们与30例无窒息的足月健康婴儿进行比较。采用临床、心电图、超声心动图及心肌酶(即肌钙蛋白-T和肌酸激酶同工酶MB水平)评估心肌功能障碍。

结果

30例病例中有23例有心肌受累证据,而对照组中有1例婴儿有与心脏受累相符的心电图证据。围产期窒息婴儿的心肌酶显著升高。病例组和对照组的肌钙蛋白-T平均水平分别为0.22±0.28和0.003±0.018,而肌酸激酶同工酶MB水平分别为121±77.4 IU/L和28.8±20.2 IU/L。与肌酸激酶同工酶MB水平相比,肌钙蛋白-T具有更高的敏感性和特异性。此外,肌钙蛋白-T水平与围产期窒息婴儿的严重程度和预后密切相关。

结论

肌钙蛋白检测有助于评估围产期窒息心肌损伤的严重程度和预后。

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