Alkholy Usama M, Abdalmonem Nermin, Zaki Ahmed, Ali Yasser F, Mohamed Soma Abdalla, Abdelsalam Nasser I, Hashim Mustafa Ismail Abu, Sekkien Mohamed Abou, Elsherbiny Yasser Makram
Pediatric Department, Zagazig University, Egypt.
Pediatric Department, Mansoura University, Egypt.
Neuropsychiatr Dis Treat. 2017 Aug 8;13:2133-2139. doi: 10.2147/NDT.S144225. eCollection 2017.
To evaluate the value of serum creatine phosphokinase-brain specific (CK-BB) and urinary lactate/creatinine (L/C) ratio as early indicators of brain damage in full-term newborns with hypoxic ischemic encephalopathy (HIE).
A case-control study including 25 full-term new-born infants with perinatal asphyxia who were admitted to neonatal intensive care unit (NICU) with a proven diagnosis of HIE, compared to 20 healthy age- and sex-matched full-term newborns. All newborn infants were subjected to full history taking, clinical examination, routine investigations (cord blood gases and complete blood picture), and assessment of serum CK-BB (cord blood, 6 and 24 hours after birth) and urinary L/C ratio (collected within the first 6 hours, on the 2nd and 3rd day after birth).
The serum CK-BB and urinary L/C ratio in infants with HIE were significantly higher in samples collected throughout the monitoring period when compared with the control group (all <0.001). The cord CK-BB and urinary L/C ratio within the first 6 hours were significantly higher in infants with severe HIE than in infants with mild and moderate HIE (<0.001). Cord CK-BB level at 12.5 U/L had 100% sensitivity and 84% specificity in the detection of severe HIE infants. Urinary L/C ratio of more than 10.5 collected within the first 6 hours after birth had 100% sensitivity and 78% specificity for the detection of severe HIE infants.
The serum CK-BB and urinary L/C ratio in HIE infants were significantly increased early in the course of the disease, which can be used as useful indicators for predicting the development of HIE.
评估血清脑型肌酸磷酸激酶（CK-BB）和尿乳酸/肌酐（L/C）比值作为足月新生儿缺氧缺血性脑病（HIE）脑损伤早期指标的价值。
一项病例对照研究，纳入25例足月围产期窒息新生儿，这些新生儿因确诊为HIE入住新生儿重症监护病房（NICU），并与20例年龄和性别匹配的健康足月新生儿进行比较。所有新生儿均进行全面病史采集、临床检查、常规检查（脐血气和血常规），并评估血清CK-BB（脐血、出生后6小时和24小时）和尿L/C比值（出生后前6小时内、出生后第2天和第3天收集）。
与对照组相比，HIE患儿在整个监测期采集的样本中血清CK-BB和尿L/C比值显著更高（均P<0.001）。重度HIE患儿在出生后前6小时内的脐血CK-BB和尿L/C比值显著高于轻度和中度HIE患儿（P<0.001）。脐血CK-BB水平为12.5 U/L时，检测重度HIE患儿的敏感性为100%，特异性为84%。出生后前6小时内收集的尿L/C比值大于10.5时，检测重度HIE患儿的敏感性为100%，特异性为78%。
HIE患儿血清CK-BB和尿L/C比值在疾病早期显著升高，可作为预测HIE病情发展的有用指标。
