Amato M, Hüppi P, Gambon R, Schneider H
Department of Obstetrics and Gynecology, University of Berne, Switzerland.
J Perinat Med. 1989;17(6):447-52. doi: 10.1515/jpme.1989.17.6.447.
Precise diagnosis of peri-intraventricular hemorrhage (PIVH) requires brain real-time ultrasound imaging procedure (US). However, maximal diagnostic efficiency of US lies between day 4 and 14 since fresh blood may initially appear sonolucent. Because of this supposed interval required for clot formation to become visible on US, serum CPK-BB estimations were performed in the first 60 hours of life to determine precise biochemical timing of PIVH. A group of 50 preterm infants less than 1500 g birth weight (1120 +/- 320 g) and 34 weeks gestation (30 +/- 3.7 weeks) was studied. Serial CPK-BB measurements were performed in serum immediately after birth (T0), then serially at time T1 (6-10 h), T2 (20-30 h), T3 (40-60 h). The incidence of PIVH diagnosed on the third day of life was 30%. Total CPK-BB values at T0 in infants who developed PIVH were significantly higher than those of patients without cerebral bleeding (70.8 +/- 30.5 vs 20.9 +/- 10.7 U/l) (p less than 0.05). The same statistically significant results were not observed analysing the CPK-BB values at T1, T2 and T3. These results suggest that most pathological conditions responsible for enzyme release occur in the pre- or perinatal period.
脑室内及脑室周围出血（PIVH）的精确诊断需要进行脑部实时超声成像检查（US）。然而，由于新鲜血液最初可能表现为透声性，US的最大诊断效率出现在出生后第4天至第14天之间。鉴于血凝块形成后在US上显示需要这一特定时间间隔，因此在出生后的前60小时内进行了血清肌酸磷酸激酶脑型（CPK-BB）测定，以确定PIVH精确的生化发生时间。对一组50名出生体重小于1500g（1120±320g）、孕龄34周（30±3.7周）的早产儿进行了研究。在出生后即刻（T0）、随后在T1（6 - 10小时）、T2（20 - 30小时）、T3（40 - 60小时）时对血清进行连续CPK-BB测量。出生后第三天诊断出的PIVH发生率为30%。发生PIVH的婴儿在T0时的总CPK-BB值显著高于无脑出血的患者（70.8±30.5对20.9±10.7 U/l）（p＜0.05）。分析T1、T2和T3时的CPK-BB值未观察到相同的统计学显著结果。这些结果表明，导致酶释放的大多数病理情况发生在产前或围产期。
