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目的探讨窒息早产儿血清肌钙蛋白(cTnⅠ)的动态变化,了解心肌损伤程度。方法对58例窒息早产儿及30例无合并症早产儿脐血、生后24h、48h、72h及7d的血清cTnI水平进行检测,结果进行单因素方差分析。结果①对照组血清cTnⅠ水平随5个时间点逐渐增高,48h、72h和脐血比较均有显著性差异(P<0.05),7d和脐血比较有显著性差异(P<0.01);窒息组血清cTnⅠ生后24h最高,与其他各个时间点比较,差异有显著性(P<0.01或P<0.05)。②cTnⅠ水平在脐血、生后24h、48h及72h几个时间点上,轻度组和对照组、重度组和对照组、重度组和轻度组间比较差异均有显著性(P<0.01)。③7d cTnⅠ水平,轻度组和对照组无明显差异(P>0.05),重度组仍明显高于对照组及轻度组(P<0.01)。结论无合并症早产儿cTnI水平随日龄增加而增高;窒息早产儿cTnⅠ水平明显增高并与窒息程度呈正相关;心肌恢复与窒息程度有关。
Objective To investigate the dynamic changes of serum cardiac troponin (cTnⅠ) in asphyxia premature infants and to understand the degree of myocardial injury. Methods Serum cTnI levels were measured in 58 asphyxiated preterm infants and 30 premature infants with no complications, and at 24h, 48h, 72h and 7d after birth. The results were analyzed by one-way ANOVA. Results ① The level of cTnⅠ in control group increased gradually at 5 time points, and there was a significant difference at 48h, 72h and cord blood (P <0.05). There was a significant difference between 7d and cord blood (P <0.01) The serum level of cTnⅠ was highest at 24 hours after birth and was significantly different from other time points (P <0.01 or P <0.05). (2) The levels of cTnⅠ in cord blood, 24h, 48h and 72h after birth were significantly different between mild group and control group, severe group and control group (P <0.01) . ③ The level of cTnⅠ at day 7d was not significantly different between mild group and control group (P> 0.05), but still higher in severe group than in control group and mild group (P <0.01). Conclusions The cTnI level of premature infants without complications is increased with the increase of age. The cTnI level of premature infants with asphyxia is significantly increased and positively correlated with the degree of asphyxia. The myocardial recovery is related to the degree of asphyxia.