Hollander D I, Wright L, Nagey D A, Wright J N, Pupkin M J, Koch T
Department of Obstetrics and Gynecology, University of Maryland School of Medicine, Baltimore.
Am J Obstet Gynecol. 1987 Oct;157(4 Pt 1):839-43. doi: 10.1016/s0002-9378(87)80068-6.
Creatinine phosphokinase and its isoenzymes (myocardial-specific MB and brain-specific BB) are elevated in the presence of specific tissue injury. The value of this serum marker as an objective indicator of perinatal asphyxia was studied. Forty-nine patients with gestational ages ranging from 36 to 42 weeks were prospectively studied. Patients who by interpretation of the fetal heart rate tracing alone were diagnosed as having fetal distress demonstrated significantly lower pH (p = 0.001) and base excess (p less than 0.0001) in umbilical venous blood. Umbilical venous cord MB (p less than 0.05) and BB (p less than 0.01) were increased in this group. Abnormal fetal heart rate patterns correlate well with acid-base abnormalities and elevated creatinine phosphokinase values. These tests may demonstrate more efficient and improved indicators of tissue injury and damage from perinatal asphyxia than clinical observation alone.
在存在特定组织损伤时，肌酸磷酸激酶及其同工酶（心肌特异性MB和脑特异性BB）会升高。研究了这种血清标志物作为围产期窒息客观指标的价值。对49例孕周在36至42周之间的患者进行了前瞻性研究。仅通过解读胎儿心率监测图被诊断为胎儿窘迫的患者，其脐静脉血中的pH值（p = 0.001）和碱剩余（p < 0.0001）显著降低。该组患者的脐静脉血中MB（p < 0.05）和BB（p < 0.01）升高。异常的胎儿心率模式与酸碱异常及肌酸磷酸激酶值升高密切相关。与单纯临床观察相比，这些检查可能是围产期窒息导致组织损伤和损害更有效、更完善的指标。
