Amato M, Nagel R, Hüppi P
Abt. für Neonatologie, Kinderklinik, Kantonsspital, Aarau.
Klin Padiatr. 1991 Sep-Oct;203(5):389-94. doi: 10.1055/s-2007-1025460.
One hundred eight newborns (gestational age 36 + 1.8 weeks and birth weight 2860 +/- 240 g) had muscle type Creatine-Kinase activity (CK-MM) assayed immediately after birth (CK-I) and serially at 6-10 h (CK-II), 20-30 h (CK-III) and 40-60 h (CK-IV) of age. Using statistical Regression analysis, CK-MM levels were correlated to four perinatal parameters: gestational age, birth weight, neonatal acidosis (pH less than 7.15), mode of delivery (vaginal/cesarean section). It was observed that CK-MM activity was dependent on gestational age and correlated to the mode of delivery at time III (600 U/l) and IV (400 U/l) comparing the mean serum values of 156 + 44 U/l observed in atraumatic delivery (p less than or equal to 0.05). Our results demonstrate markedly higher levels of CK-MM following vaginal delivery especially if complicated by forceps, vacuum and breech presentation, suggesting that birth trauma may be responsible for this phenomenon.
108例新生儿(胎龄36 + 1.8周,出生体重2860 +/- 240 g)在出生后立即测定肌肉型肌酸激酶活性(CK-MM)(CK-I),并在出生后6 - 10小时(CK-II)、20 - 30小时(CK-III)和40 - 60小时(CK-IV)连续测定。采用统计学回归分析,CK-MM水平与四个围产期参数相关:胎龄、出生体重、新生儿酸中毒(pH小于7.15)、分娩方式(阴道分娩/剖宫产)。观察到CK-MM活性取决于胎龄,并且在III期(600 U/l)和IV期(400 U/l)时与分娩方式相关,与无创伤分娩时观察到的平均血清值156 + 44 U/l相比(p小于或等于0.05)。我们的结果表明,阴道分娩后CK-MM水平明显更高,尤其是在伴有产钳、真空吸引和臀位分娩等并发症时,提示出生创伤可能是导致这种现象的原因。