Roby P V, Glenn C M, Watkins S L, Baxter L M, Kenny M A, Nazar-Stewart V, Mayock D E
Department of Laboratory Medicine, University of Washington, Seattle, USA.
Am J Perinatol. 1996 Nov;13(8):453-5. doi: 10.1055/s-2007-994427.
To determine whether an association exists between antenatal cocaine exposure and elevated levels of creatine kinase (CK) and myoglobin in umbilical cord blood collected upon delivery.
105 anonymous maternal urines with corresponding infant umbilical cords bloods.
Maternal urines were screened for cocaine metabolites by the Syva EMIT assay, with positive specimens confirmed by gas chromatography/mass spectrometry. For all 8 positives, plus the first 47 of the negatives collected, matched infant cord blood specimens were analyzed for myoglobin by radioimmunoassay and CK by kinetic enzyme activity assay. Cord bloods matched to the remaining 50 cocaine-negative urines were not analyzed. A two-tailed Mann-Whitney test was used to evaluate the significance of differences in CK and myoglobin levels between the two groups.
CK levels were evaluated twofold in the cocaine-positive group as compared to the cocaine negative group (mean 383 +/- 260 vs. 189 +/- 68 IU/L, p = 0.005). Myoglobin levels were twofold higher in the cocaine-positive group compared to the cocaine negative group (mean 55.9 +/- 37.1 vs. 33.3 +/- 26.8 ng/mL, p = 0.077).
Antenatal cocaine exposure is associated with elevated cord blood CK, and possibly with elevated cord blood myoglobin. Additional studies, using larger study populations and more sensitive methods of detecting antenatal cocaine exposure, along with detailed follow-up examination of infants, are indicated.
确定分娩时采集的脐带血中，产前可卡因暴露与肌酸激酶（CK）和肌红蛋白水平升高之间是否存在关联。
105份匿名孕妇尿液及相应的婴儿脐带血。
采用Syva EMIT分析法筛查孕妇尿液中的可卡因代谢物，阳性标本通过气相色谱/质谱法进行确认。对所有8份阳性标本，以及采集的前47份阴性标本，其配对的婴儿脐带血标本采用放射免疫分析法检测肌红蛋白，采用动力学酶活性分析法检测CK。与其余50份可卡因阴性尿液配对的脐带血未进行分析。采用双侧曼-惠特尼检验评估两组之间CK和肌红蛋白水平差异的显著性。
与可卡因阴性组相比，可卡因阳性组的CK水平评估值高出两倍（均值383±260 vs. 189±68 IU/L，p = 0.005）。与可卡因阴性组相比，可卡因阳性组的肌红蛋白水平高出两倍（均值55.9±37.1 vs. 33.3±26.8 ng/mL，p = 0.077）。
产前可卡因暴露与脐带血CK升高有关，可能也与脐带血肌红蛋白升高有关。需要开展更多研究，使用更大的研究群体和更敏感的产前可卡因暴露检测方法，并对婴儿进行详细的随访检查。
