Niklinski W, Palynyczko Z, Jozwik M, Sledziewski A
Clinic of Gynecology, Medical Academy, Bialystok, Poland.
J Perinat Med. 1987;15(4):350-4. doi: 10.1515/jpme.1987.15.4.350.
It has been suggested that perinatal asphyxia is not generally followed by neurological impairment unless there is preexisting chronic fetal distress. In cases of brain damage one can observe elevated levels of CK-BB. The purpose of our study was to evaluate CK isoenzymes in umbilical cord blood sera of newborns affected by chronic fetal distress. Fetal distress reflected by placental dysfunction was characterized by a diminished HPL level and decreased activity of CAP. We estimated CK isoenzymes with the use of DEAE-sepharose CL-6B column chromatography. Total CK activity was measured using kits supplied by Boehringer-Mannheim (Monotest CK-NAC aktiviert). The clinical state of examined newborns was estimated. Investigations were carried out in the group of 57 infants delivered after 37 weeks of gestation. Total CK activity in cord sera ranged from 40 to 400 U/l. Our results showed a significant rise of CK-BB activity in cord sera of newborns delivered from pregnancies with placental dysfunction (figure 2) as well as in cases of asphyxiated infants (figure 3). We were unable to demonstrate differences in total CK, CK-MM and CK-MB activities in all examined groups of newborns. Other authors have confirmed that severe asphyxia results in increase in CK-BB activity in cord blood. Infants with ominous fetal heart rate patterns have higher CK-BB activity. There are several possible sources for CK-BB activity in umbilical cord blood sera, i.e. fetal brain, lung, gastrointestinal tract, placenta and uterus. It appears that the brain is most likely the source of elevated CK-BB activity found in cord blood in cases of placental dysfunction.
有人提出，除非存在先前的慢性胎儿窘迫，否则围产期窒息一般不会导致神经损伤。在脑损伤的病例中，可以观察到CK-BB水平升高。我们研究的目的是评估受慢性胎儿窘迫影响的新生儿脐带血血清中的肌酸激酶同工酶。胎盘功能障碍所反映的胎儿窘迫的特征是HPL水平降低和CAP活性下降。我们使用DEAE-琼脂糖CL-6B柱色谱法估计肌酸激酶同工酶。总CK活性使用勃林格殷格翰公司提供的试剂盒（Monotest CK-NAC aktiviert）进行测量。评估了所检查新生儿的临床状态。对57例妊娠37周后分娩的婴儿进行了调查。脐带血清中的总CK活性范围为40至400 U/l。我们的结果显示，胎盘功能障碍妊娠分娩的新生儿脐带血清中CK-BB活性显著升高（图2），窒息婴儿的情况也是如此（图3）。我们未能在所有检查的新生儿组中证明总CK、CK-MM和CK-MB活性存在差异。其他作者已经证实，严重窒息会导致脐带血中CK-BB活性增加。胎儿心率异常的婴儿CK-BB活性较高。脐带血血清中CK-BB活性有几种可能的来源，即胎儿脑、肺、胃肠道、胎盘和子宫。在胎盘功能障碍的情况下，脐带血中升高的CK-BB活性似乎最有可能来源于脑。
