Kocylowski Rafal D, Dubiel Mariusz, Gudmundsson Saemundur, Sieg Ina, Fritzer Elfriede, Alkasi Ozkan, Breborowicz Gregory H, von Kaisenberg Constantin S
Department of Obstetrics and Gynecology, Poznan University of Medical Sciences, Poznan, Poland.
Am J Obstet Gynecol. 2009 Mar;200(3):273.e1-273.e25. doi: 10.1016/j.ajog.2008.10.009. Epub 2009 Jan 24.
We sought to establish references ranges and to test the hypothesis that biochemical tissue-specific markers for the heart in umbilical cord blood of newborns with cardiac defects and intrauterine growth restriction (IUGR) are abnormal.
A prospective study was conducted. Serum samples of the umbilical vein (n = 280) and artery (n = 156) from 599 healthy newborns at 37(+0)-42(+0) weeks of gestation were collected. Total creatine kinase (CK), CK-MB heart type (CK-MB), cardiac troponin T (cTnT), myoglobin, N-terminal pro-B-type natriuretic peptide (NT-proBNP), and S100 were measured. Reference ranges for each marker were constructed. Concentrations of tissue-specific markers from umbilical cord blood of neonates with cardiac defects (n = 10) and IUGR (n = 41) were plotted against the established reference ranges.
Reference ranges for each studied marker were established for both umbilical artery and vein. In fetuses with cardiac defects, both NT-proBNP (4/6 [66%] in the artery, 7/10 [70%] in the vein) and cTnT (2/10 [20%] in the vein) were increased. In fetuses with IUGR in the vein, NT-proBNP (10/41 [24%]) and cTnT (5/41 [12%]) were increased, whereas S100 (9/41 [21%]) was decreased.
In a subset of neonates with cardiac defects or growth restriction, irrespective of the pH at birth, tissue-specific injury markers for the heart in umbilical cord blood are abnormal.
我们试图建立参考范围，并检验以下假设：患有心脏缺陷和宫内生长受限（IUGR）的新生儿脐带血中，心脏的生化组织特异性标志物异常。
进行了一项前瞻性研究。收集了599例妊娠37（+0）-42（+0）周的健康新生儿的脐静脉（n = 280）和脐动脉（n = 156）血清样本。检测了总肌酸激酶（CK）、心肌型肌酸激酶同工酶（CK-MB）、心肌肌钙蛋白T（cTnT）、肌红蛋白、N末端B型脑钠肽原（NT-proBNP）和S100。构建了每个标志物的参考范围。将患有心脏缺陷（n = 10）和IUGR（n = 41）的新生儿脐带血中组织特异性标志物的浓度与既定参考范围进行对比绘制。
为脐动脉和脐静脉分别建立了每个研究标志物的参考范围。在患有心脏缺陷的胎儿中，NT-proBNP（动脉中4/6 [66%]，静脉中7/10 [70%]）和cTnT（静脉中2/10 [20%]）均升高。在脐静脉中有IUGR的胎儿中，NT-proBNP（10/41 [24%]）和cTnT（5/41 [12%]）升高，而S100（9/41 [21%]）降低。
在一部分患有心脏缺陷或生长受限的新生儿中，无论出生时的pH值如何，脐带血中心脏的组织特异性损伤标志物均异常。
