血清烯醇化酶和肌钙蛋白Ⅰ及β2-微球蛋白水平变化在新生儿窒息中的临床意义

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目的:探讨血清烯醇化酶和肌钙蛋白Ⅰ及β2-微球蛋白在新生儿窒息中的变化及其意义。方法:选择24例窒息新生儿(轻度窒息14例,重度窒息10例)和26例同期正常足月新生儿为研究对象。在出生后24h内和治疗后第7d分别抽血,采用ELISA法及乳腺增强免疫比浊法检测各组血清烯醇化酶、肌钙蛋白Ⅰ及β2-微球蛋白含量。结果:(1)窒息新生儿出生第1d血清烯醇化酶、肌钙蛋白Ⅰ及β2-微球蛋白含量均显著高于对照组(P均<0.01),且重度窒息组较轻度窒息组差异有统计学意义(P<0.01);(2)窒息患儿经7d治疗,重度窒息组较对照组(P<0.01)和轻度窒息组(P<0.05)差异有统计学意义,轻度窒息组较对照组差异无统计学意义(P>0.05);轻、重度窒息组较出生时各参数含量显著下降(P<0.01)。结论:(1)血清烯醇化酶、肌钙蛋白Ⅰ及β2-微球蛋白水平变化与窒息程度密切相关;(2)新生儿窒息时伴有脑、心、肾等多脏器的损伤,轻度窒息儿经治疗在短期内即可恢复,重度窒息儿不能快速恢复,对预后判断具有重要临床价值。 Objective: To investigate the changes and clinical significance of serum enolase, troponin I and β2-microglobulin in neonatal asphyxia. Methods: 24 neonates with asphyxia (mild asphyxia in 14 cases, severe asphyxia in 10 cases) and 26 normal full-term newborns in the same period were selected as the study objects. The blood samples were collected within 24 hours after birth and on the 7th day after treatment. The levels of serum enolase, troponin I and β2-microglobulin in each group were determined by ELISA and breast enhanced turbidimetry. Results: (1) Serum levels of serum enolase, troponin I and β2-microglobulin at 1 day after birth in asphyxiated newborns were significantly higher than those in control group (all P <0.01), and those in severe asphyxia group were lower than those in mild asphyxia group (P <0.01). (2) There was a significant difference between the asphyxia group and the control group (P <0.01) and mild asphyxia group (P <0.05) There was no significant difference between the control group and the control group (P> 0.05). The levels of each parameter in the mild and severe asphyxia groups were significantly lower than those in the control group (P <0.01). Conclusions: (1) Serum enolase, troponin I and β2-microglobulin levels are closely related to the degree of asphyxia; (2) neonatal asphyxia accompanied by multiple organ damage such as brain, heart and kidney, Degree of suffocation treatment can be recovered in a short period of time, severe asphyxia can not be quickly restored, the prognostic judgment has important clinical value.
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