hupchinw/re7EmaikzRakvx佃chinawmehcn••临床研究NT-proBNP联合超声Tei指数评估新生儿窒息后心肌损伤的临床价值季坚卫，杨莲芳，龚向英【摘要】目的探讨血浆N末端脑钠肽前体(NT-proBNP)联合超声Tei指数评估新生儿窒息后心肌损伤的临床价值。方法对在义乌市中心医院住院的轻度窒息组41例和重度窒息组21例，分别于急性期(生后24h内)及恢复期(治疗后7d)检测血清CK-MB、cTnl、血浆NT-proBNP及超声Tei指数：选择30例高危新生儿为对照组，检测血清CK-MB、cTnL血浆NT-proBNP及超声Tei指数。结果急性期窒息组新生儿血清CK-MB、cTnl、血浆NT-proBNP水平及超声Tei指数高于对照组，差异有统计学意义(P<0.05)o急性期重度窒息组血清CK-MB、cTnk血浆NT-proBNP水平及超声Tei指数高于轻度窒息组，差异均有统计学意义(P<0.05)。窒息组新生儿恢复期血清CK-MB、cTnl血浆NT-pn)BNP水平及超声Tei指数与急性期相比，均较治疗前下降，差异均有统计学意义(P<0.05)。窒息组新生儿血浆NT-proBNP水平与心脏超声Tei指数均呈正相关(P<0.05)。结论联合监测新生儿窒息患儿血浆NT-pn)BNP及心脏超声Tei指数，井动态监测两项指标，有助于新生儿窒息患儿心肌损害的早期诊断及评价治疗效果。【关键词】新生儿窒息：N端脑利钠肽前体：Tei指数：心肌损伤【中图分类号】R272.1【文献标识码】AClinicalValueofNT-proBNPCombinedwithUltrasoundTeiIndexinEvaluatingMyocardialInjuryafterNeonatalAsphyxiaJIJianwei,YANGLianfang,GONGXicmgyingDepartmentofNeonatology,YiiuuCentralHospital,Yiwu322000,China[Abstract]ObjectiveToinvestigatetheclinicalvalueofplasmaN-terminalprobrainnatriureticpeptide(NT-proBNP)combinedwithultrasoundTeiindexintheassessmenlofmyocardialinjuryafterneonatalasphyxia.MethodsSerumCK-MB,cTnl,plasmaNT-proBNPandultrasoundTeiindexweremeasuredin42patientswithmildasphyxiaand23patientswithsevereasphyxiainacutephase(within24hoursafterbirth)andconvalescentstage(7daysaftertreatment).SerumCK-MB.cTnl.plasmaNT-proBNPandultrasoundTeiindexweremeasuredin30highriskneonatesascontrolgroup.ResultsthescrumCK-MB,cTnl,plasmaNT-proBNPlevelandultrasonicTeiindexintheacuteasphyxiagroupweresignificantlyhigherthanthoseinthecontrolgro叩(P<0.05).TheserumCK-MB,cTnl,plasmaNT-proBNPlevelandultrasoundTeiindexintheacutesevereasphyxiagroupweresignificantlyhigherthanthoseinthemildasphyxiagroup(P<0.05).Comparedwiththeacutephase,theserumCK-MB,cTnlplasmaNT-proBNPlevelandultrasonicTeiindexinasphyxiagroupwerelowerthanthosebeforetreatment,andlhedifferenceswereallthesame.Thesignificanceofplanningandlearning(P<0.05).TherewasapositivecorrelationbetweenplasmaNT-proBNPlevelandcardiacultrasoundTeiindexinasphyxiagroup.ConclusionCombinedmonitoringofplasmaNT-proBNPandcardiacultrasoundTeiindexinchildrenwithneonatalasphyxia,anddynamicmonitoringoftwoindicators,canhelpearlydiagnosisandevaluationofmyocardialdamageinneonateswithasphyxia.[Keywords]Neonatalasphyxia;N-ienninalbrainnatriureticpeptideprecursor;Teiindex;Myocardialinjury新生儿窒息是一种常见的新生儿疾病，发生率据报道在外国为5.0%〜6.0%,国内为4.7%〜8.9%0随着医学科学的发展，新生儿窒息的发生率和死亡率正在逐年下跌，但一旦出现新生儿窒息，容易导致患儿心肌受到损害，使得多器官功能不能正常运行，最终患儿心功能出现障碍⑵。本文主要研究新生儿窒息患儿NT-proBNP联合超声Tei指数，分析窒息新生儿心肌损害的早期诊断及治疗效果评价。基金项目：2018年义乌市科研项目(18-3-73)作者单•位：322000浙江省义乌市中心医院新生儿科1资料与方法1.1一般资料选择义乌市中心医院新生儿科2018年3月-2019年5月间收治住院的62例窒息新生儿作为研究对象，男32例、女30例，出生体重2.6〜4.1kg,平均(2.99+0.51)kg,出生孕周37〜40周，平均(38.87±1.09)周，诊断标准参照中...