Weiss E, Ulrich S, Berle P, Picard-Maureau A
Department of Obstetrics and Gynecology, Johannes Gutenberg University, Mainz, Fed. Rep. of Germany.
J Perinat Med. 1994;22(3):219-26. doi: 10.1515/jpme.1994.22.3.219.
The purpose of this study is to determine the levels of brain type isoenzyme of creatine kinase (CK-BB) as a possible indicator of a pre-existing intrauterine brain-cell damage in cord blood sera of fetuses with preceding absent or reverse end-diastolic flow velocities of the umbilical arteries (AREDFV). CK-BB isoenzyme activities were determined in umbilical cord sera of 13 newborn infants with preceding AREDFV and in 14 fetuses with low end-diastolic flow velocities (LEDFV) of the umbilical arteries. 50 newborn infants with elective cesarean section and normal umbilical artery blood flow velocity waveforms were used as controls. Two-tailed Student's t-test and Fischer's exact test were used for statistical evaluation of the results. CK-BB isoenzyme activity did not depend on gestational age. Fetuses with AREDFV showed a significant increase in CK-BB values, whereas fetuses with LEDFV had CK-BB activities within the normal range of the controls. The elevated CK-BB values of the AREDFV group were not correlated with fetal acidosis at birth. Brain-cell injury with leakage of CK-BB isoenzyme might be present in fetuses with AREDFV even before (preterm) delivery.
本研究的目的是测定肌酸激酶脑型同工酶（CK-BB）的水平，作为脐动脉舒张末期血流速度缺失或反向（AREDFV）的胎儿脐带血血清中可能存在的宫内脑细胞损伤的一个指标。测定了13例先前有AREDFV的新生儿脐带血清以及14例脐动脉舒张末期血流速度低（LEDFV）的胎儿的脐带血清中的CK-BB同工酶活性。选取50例择期剖宫产且脐动脉血流速度波形正常的新生儿作为对照。结果采用双侧t检验和费舍尔精确检验进行统计学评估。CK-BB同工酶活性不依赖于胎龄。有AREDFV的胎儿CK-BB值显著升高，而有LEDFV的胎儿CK-BB活性在对照组正常范围内。AREDFV组升高的CK-BB值与出生时胎儿酸中毒无关。即使在（早产）分娩前，有AREDFV的胎儿可能就存在CK-BB同工酶渗漏导致的脑细胞损伤。
