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为探讨血清酶学改变在新生儿缺血缺氧性脑病(HIE)中的临床意义,作者采用自动生化分析仪对36例HIE患儿在急性期和治疗后分别测定了血清中的AST、CPK、LDH和α-HBD活性。结果在发病初期四种酶均明显增高,与对照组以及治疗后的测定值比较均有非常显著的差异(P<0.01);治疗后7～14天的测定值与对照组比较,前三者仍高于对照(P<0.05);本文还对不同临床分度患儿在急性期的血清酶测定值作比较,结果显示,各临床分度之间的血清酶改变,无显著性差异(P>0.05)。表明血清酶学改变与脑损伤并无直接的因果关系。从本组病例观察,本病血清酶的改变常在2-3周后渐趋正常,因此,在治疗时使用自由基清除剂和神经营养药,疗程在2周左右是适宜的和必要的。
In order to explore the clinical significance of serum enzymology changes in neonatal hypoxic-ischemic encephalopathy (HIE), we used automatic biochemical analyzer to measure the serum levels of AST, CPK , LDH and alpha-HBD activity. Results All the four enzymes were significantly increased in the early stage of onset, compared with the control group and the measured values after treatment (P <0.01). The measured values of 7 to 14 days after treatment were significantly lower than those of the control group Still higher than the control (P <0.05). In addition, the serum enzyme values in acute stage of children with different clinical scores were compared. The results showed that there was no significant difference in serum enzyme between clinical grades (P > 0.05). This suggests that there is no direct causal relationship between serum enzymatic changes and brain damage. Observed from this group of patients, the change of serum enzyme in the disease often 2-3 weeks later became normal, therefore, the use of free radical scavengers and neurotrophic drugs in the treatment, the course of about 2 weeks is appropriate and necessary.