Lee Inn-Chi, Yu Chin-Sheng, Wong Swee-Hee, Lue Ko-Huang
Division of Pediatric Neurology, Department of Pediatrics, Chung Shan Medical University Hospital, Taichung 402, Taiwan.
Institute of Medicine, School of Medicine, Chung Shan Medical University, Taichung 402, Taiwan.
J Clin Med. 2021 Sep 5;10(17):4010. doi: 10.3390/jcm10174010.
Troponin I is a biomarker for cardiac injury in children. The role of troponin I in neonatal Hypoxic-Ischemic encephalopathy (HIE) may have valuable clinical implications. Troponin I levels were measured within 6 h of birth to determine their relationship to HIE stage, short-term cardiac functional outcomes, and neurodevelopmental outcomes at 1 year. Seventy-three patients were divided into two groups: mild HIE and moderate to severe HIE. Troponin I levels within 6 h of birth were obtained in 61 patients, and were significantly higher in patients with moderate to severe HIE than in patients with mild HIE (Mann-Whitney U test, U = 146, 0.001). A troponin I cut-off level of ≥60 pg/mL predicted moderate to severe HIE with a specificity of 81.1% and a negative prediction rate of 76.9%. A troponin I cut-off level of ≥180 pg/mL was significantly (χ (1, = 61) = 33.1, = 0.001, odds ratio 96.8) related with hypotension during first admission and significantly (χ (1, = 61) = 5.3, = 0.021, odds ratio 4.53) related with abnormal neurodevelopmental outcomes at 1 year. Early troponin I level may be a useful biomarker for predicting moderate to severe HIE, and initialization of hypothermia therapy.
肌钙蛋白I是儿童心脏损伤的生物标志物。肌钙蛋白I在新生儿缺氧缺血性脑病（HIE）中的作用可能具有重要的临床意义。在出生后6小时内测量肌钙蛋白I水平，以确定其与HIE分期、短期心功能结局以及1岁时神经发育结局的关系。73例患者分为两组：轻度HIE组和中重度HIE组。61例患者获得了出生后6小时内的肌钙蛋白I水平，中重度HIE患者的肌钙蛋白I水平显著高于轻度HIE患者（曼-惠特尼U检验，U = 146，P = 0.001）。肌钙蛋白I临界值≥60 pg/mL预测中重度HIE的特异性为81.1%，阴性预测率为76.9%。肌钙蛋白I临界值≥180 pg/mL与首次入院时的低血压显著相关（χ²(1, n = 61) = 33.1，P = 0.001，比值比96.8），与1岁时异常神经发育结局显著相关（χ²(1, n = 61) = 5.3，P = 0.021，比值比4.53）。早期肌钙蛋白I水平可能是预测中重度HIE以及启动低温治疗的有用生物标志物。
