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评价血浆心肌肌钙蛋白I（cTnI）、肌酸激酶心型同工酶质量（CK-MB-mass）、肌酸激酶心型同工酶质量/肌酸激酶活性的比值（CK-MBmass/CK）对围产期窒息后心肌损伤诊断价值,对71例围产期窒息新生儿及27例对照组新生儿生后6～48小时血浆cTnI、CK-MBmass及CK水平进行测定并计算CK-MBmass/CK比值,运用Wilcoxon秩和检验等方法进行分析。结果显示:（1）新生儿窒息伴胎儿窘迫组（23例）cTnI、CK-MBmass、CK均显著高于对照组（27例）;新生儿窒息伴胎儿窘迫组CK-MB-mass、CK显著高于单纯窘迫组（38例）;单纯窒息组（10例）与对照组相比,仅CK-MB-mass/CK明显降低,其它指标差异无显著性。（2）围产期窒息组重度心脏损害患儿（8例）cTnI、CK-MBmass、CK均明显高于该组无重度心脏损害患儿（63例）。（3）重度窒息组（17）例仅CK-MBmass、CK明显高于轻度窒息组（16例）。因此,新生儿严重缺氧时,血浆cTnI、CK-MBmass、CK均明显增高,表明存在心肌损伤。CTnI虽对心肌损伤有高度特异性,但敏感性低于CK-MBmass、CK,且受胎龄影响;在判断早产儿心肌损伤时有一定的局限性。CK-MBmass/CK比值不宜作为围产期窒息后心肌损伤的生化指标。
The plasma levels of cTnI, CK-MB-mass, and creatine kinase isoenzyme mass / creatine kinase activity (CK-MBmass / CK ) On the diagnosis of myocardial injury after perinatal asphyxia, plasma levels of cTnI, CK-MBmass and CK in 71 neonates with perinatal asphyxia and 27 controls were measured 6 to 48 hours after birth and CK-MBmass was calculated / CK ratio, the use of Wilcoxon rank sum test and other methods for analysis. The results showed that: (1) cTnI, CK-MBmass and CK in neonatal asphyxia with fetal distress group were significantly higher than those in control group (27 cases); CK-MB-mass and CK in neonatal asphyxia with fetal distress group were significantly (38 cases). Compared with the control group, CK-MB-mass / CK decreased only in the simple asphyxia group (10 cases), but there was no significant difference in other indexes. (2) The cTnI, CK-MBmass and CK were significantly higher in infants with severe heart damage (8 cases) in perinatal asphyxia group than in those without severe heart damage (63 cases). (3) CK-MBmass and CK in severe asphyxia group (17) were significantly higher than those in mild asphyxia group (16 cases). Therefore, severe neonatal hypoxia, plasma cTnI, CK-MBmass, CK were significantly increased, indicating the existence of myocardial injury. Although CTnI has a high specificity for myocardial injury, its sensitivity is lower than that of CK-MBmass and CK, and it is affected by gestational age. CTnI has some limitations in judging myocardial injury in premature infants. CK-MBmass / CK ratio should not be used as biochemical indicators of myocardial injury after perinatal asphyxia.