腺苷治疗新生儿窒息并心肌损害疗效观察.docVIP

腺苷治疗新生儿窒息并心肌损害疗效观察【摘要】 目的 观察联合腺苷治疗对新生儿窒息并心肌损害的疗效影响。方法 60例窒息新生儿随机分为治疗对照组和腺苷治疗组，均予常规治疗，腺苷治疗组同时予腺苷治疗，分别在1、7 d测定各组新生儿血清心肌酶水平。另外，选取30例正常足月新生儿作正常对照。结果 联合腺苷治疗显著降低肌酸激酶同工酶（CK-MB）、乳酸脱氢酶（LDH）、门冬氨酸氨基酸转移酶（AST）、肌酸激酶（CK）和α-羟丁酸脱氢酶（HBDH）水平（P＜0.01），治疗总有效率高于治疗对照组（P＜0.05）。结论 联合腺苷治疗能有效降低心肌酶，促进窒息后新生儿损伤心肌的恢复，具有临床应用价值。? 【关键词】腺苷；新生儿窒息；心肌酶?? An observation of curative effect of adenosine on cardiac damage induced byasphyxia in neonates LI Yi-ming , ZHANG Lu, XIE You-ping, et al. Maternal and Child Health Hospital , Zhuhai Guangdong 519001,China ? 【Abstract】 Objective To observe the curative effect on asphyxiated newborn with heart muscle damage curing by adenosine combined with conventional drugs. Methods The asphyxiated neonates were randomly divided into two groups. Neonates in control group were cured by conventional therapy, and in adenosine group were cured by adenosine at the same time.The serum levels of enzymes were measured in all newborns 1d and 7d after birth. Results he levels of cardiac enzymes in adenosine treatment group were significantly lower than that in conventional treatment group（P＜0.01, respectively）, and the curative effect of adenosine group was higher than conventional therapy（P＜0.05）. Conclusion Adenosine can attenuate the serum levels of cardiac enzymes, and improve the recovery of damaged heart induced by asphyxia in neonates. Adenosine can be widely used in clinic.? 【Key words】Adenosine；Asphyxiated neonate;Cardiac enzymes ? 新生儿窒息并心肌损害是围产期常见的严重并发症之一。腺苷是近年来在缺血预适应中心肌保护的研究热点。本研究以缺氧性心肌损害新生儿为研究对象，在常规治疗的基础上再用环磷腺苷（广东宏远集团药业有限公司生产），通过观察治疗前后心肌酶谱水平和心率、心电图的变化，以探讨腺苷治疗新生儿缺氧所致心肌损伤的疗效及作用机制。? 1 资料与方法? 1.1 研究对象 患儿组：为2005年8月至2007年10月珠海市妇幼保健院新生儿病区入住的出生时窒息且心电图和心肌酶异常的60例足月新生儿还有先天性心脏病，其中男39例，女21例。采用虞人杰等的诊断标准[1]中度窒息组32例，重度窒息组28例，入院24 h内行心电图检测，并按随机化原则将他们分为治疗对照组和腺苷治疗组。正常对照组：为同期入住本院产科自然分娩且心电图和心肌酶正常的30例足月新生儿，男18例，女12例。? 1.2 诊断标准 新生儿窒息后心肌损害诊断[1]依据:发生心力衰竭,缺氧性心肌损害,严重心律紊乱,严重心电图改变并有心动超声证实左右心功能异常及肌酸激酶同工酶（CK-MB）增高(需临床1项加酶异常1项)。轻至中度心肌损害：心律紊乱，心电图ST-T波改变，CK-MB增高；凡有