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[摘要]目的：评价窒息新生儿心肌酶及肾功能水平及与窒息程度的关系。方法：86例窒息新生儿作为观察对象,重度窒息37例（A组）, 轻度窒息49例（B组）,正常新生儿45例为对照组(C 组)。于生后24 h采集静脉血检测谷草转氨酶(AST )、谷丙转氨酶(ALT)、乳酸脱氢酶(LDH)、羟丁酸脱氢酶(HBDH)、肌酸激酶(CK)及肌酸激酶心型同工酶(CK-MB)、肌酐(Cr)、尿素氮(BUN)、β2-微球蛋白(β2-MG)，各组间进行比较分析。结果：与正常新生儿相比，窒息新生儿心肌酶水平、Cr、BUN、β2-MG均显著升高,窒息程度越重，升高越明显。结论：窒息可引起新生儿心、肾功能损害，且与窒息程度密切相关。
[关键词] 窒息；新生儿；心肌酶；肾功能
[中图分类号] R446.11 [文献标识码]A [文章编号]1674-4721（2009）05（a）-０46－０2
Clinical significance ofdeterminations of cardiac enzymes and renal function after asphyxia in neonates
SUN Wei， LU Lihua
(Department of Pediatrics, Fengxian CentralHospital,Shanghai201400，China)
[Abstract] Objective: To evaluate the correlation between the changes of cardiac enzymes and renal function and the severity of asphyxia in neonates. Methods: Thirty-seven neonates with severe asphyxia(Group A), 49 cases with mild asphyxia( Group B) and 45 healthy infants( Group C ) were chosen. The levels of glutamic-oxalacetic transaminase(AST)，glutamic-pyruvic transaminase(ALT)，lactic dehydro-genase(LDH)，hydroxybutyric dehydrogenase(HBDH)， creatine kinase(CK)，MB isoenzyme of creatine kinase(CK-MB)，creatinine (Cr)， blood ureanitrogen(BUN)，beta-2-microglobulin(β2 - MG) in venous blood were measured simultaneously at 24 houn timepoint after birth, and all the biochemical indicators were compared among three groups. Results: Compared with healthy infants, the levels of all the biochemical indicators significantly increased in neonates with asphyxia.The higher level of severity of asphyxia，the higher levels of all these biochemical indicators. Conclusion: Asphyxia could cause injury to renal and cardiac function of neonates with asphyxia,there was a close correlation between the changes of cardiac enzymes and renal function and the severity of asphyxia in neonates.
[Key words] Asphyxia; Neonate; Newborn; Cardiac enzymes; Renal function
新生儿窒息是儿科最常见的危重急症之一,也是围生期死亡和致残的重要原因之一。新生儿窒息可引起多器官功能损害，并随窒息程度的加重而加重[1]。因此,本研究观察窒息新生儿复苏后，心、肾功能受损程度，为实施积极干预及判断预后寻求临床证据。
1 资料与方法
1.1 一般资料
2004年11月～2008年10月在上海市奉贤区中心医院儿科住院的足月窒息新生儿86例,根据出生后1 min Apgar评分。其中重度窒息新生儿37例（A组）,男22例，女15例；轻度窒息新生儿49例（B组）,男20例,女29例。正常新生儿45例作为对照组（C组）, 其中男27例，女18例，各组观察对象母孕期均健康,无特殊药物应用史，新生儿出生体重、胎龄比较，差异无统计学意义(P>0.05) 。
1.2 方法
于生后16～24 h取患儿静脉血2～3 ml,离心(3000 r/min, 5 min)后取血清。血清AST、ALT、LDH、H-BDH、CK、CK-MB、Cr、BUN测定仪器为日本HITACHI公司生产的7060A型全自动生化分析仪, 所有试剂由Beckman 公司原装进口。
1.3统计学处理
所有计量资料以x±s表示, 使用SPSS12.0软件包进行统计学分析, 各组数据进行t 检验，P
