围产期窒息新生儿心肌损害的评价.docVIP

围产期窒息新生儿心肌损害的评价 【摘要】目的：探讨宫内窘迫和/或伴产后窒息致新生儿缺氧、缺血性心肌损害时的酶学及心电图变化。方法：对照组（A组，20例），窒息新生儿分为产后窒息组（B组，29例）和宫内窘迫伴产后窒息组（C组，23例），测定其血清AST、CK\|MB、LDH、αHBDH及ECG。结果：C组上述心肌酶分别明显高于B组和A组，P001或005），而B组的又高于A组（P005）。C组的心电图变化明显多于B组（P005）。结论：宫内窘迫伴产后窒息致心肌损害更加严重。 【关键词】 窒息 新生儿 心肌缺血 心电描记术 Evaluation of myocardium damage of newborn suffering from asphyxia in perinatal period by measurement of myocardium enzyme and electrocardiogram/ZHENG Lin|qin，LIN Yu|ping，SU Hui|lan//Chinese Journal of Cardiovascular Rehabilitation Medicine,2007,16(1):36 Abstract：Objective:To study the levels of the myocardium enzyme and the changers of ECG in newborn suffering from intrauterine asphyxia and/or postpartum asphyxiaMethods:The serum levels of AST,CK|MB,LDH,alpha;HBDH were measured and ECG was examined in the following three groups:the control group (group A,n=20),the postpartum asphyxia group(group B,n=29)and the intrauterine embarrass complicated partum asphyxia group (group C,n=23).Results:The levels of AST,CK|MB,LDH,alpha;HBDH in group C were higher than those in group B and group A respectively (P001 or 005),Furthermore, the above levels of enzymes in B group were higher than those in group A(P005)The changes of ECG in group C were more than those in group B(P005)Conclusion:Both intrauterine and postpartum asphyxia may cause greater myocardium damage in newborn. Authorprime;s　address：Department of Paediatrics, The Second Hospital of Fuzhou,Fuzhou,Fujian，350007，China Key words：Asphyxia,newborn；Myocardial ischemia；Electrocardiography 围产期窒息是指胎儿因缺氧发生宫内窘迫和/或娩出过程中引起的呼吸循环障碍。宫内窘迫是产后窒息的重要原因之一，窒息引起器官损害可达748％[1]。本文主要报道宫内窘迫和／或伴产后窒息对心肌的损害。 1 资料与方法 11 一般资料2002年l月至2006年5月住我科的窒息新生儿 52例，其中男31 例， 女 21例；早产儿10例，体质量（21±06）kg；足月儿42例，体质量（34±07）kg。全部病例均经过Apgar评分。对照组（A组）20例，Apgar评分ge;8分，生后情况好，无紫绀、呼吸循环、神经症状。产后窒息组（B组）29例,1 min Apgar评分4～7分，5 min Apgar评分ge;8分。宫内窘迫伴产后窒息组（C组）23例，l min Apgar评分le;3分，和/或＞5 min Apgar评分le;5分。3组间性别、体质量、分娩方式无统计学差异（P均005） 12 方法全部对象均于产后48 h内空腹抽取股静脉血3 ml送检。所有样本均用同一台美国贝克曼CX-7型全自动生化分析仪进行天冬