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目的:了解本地区仫佬、壮、汉民族新生儿高胆红素血症并心肌损伤的酶学及心电改变。方法:选择仫佬族、壮族和汉族3个民族新生儿高胆红素血症患儿(观察组)90例,同期生理性黄疸患儿(对照组)54例,对比分析各组的胆红素水平与心肌酶谱改变的关系,并对心电图进行动态监测。结果:(1)观察组CK、CK-MB、LDH水平升高与对照组比较差异均有统计学意义(P<0.05或0.01);CK-MB/CK>6%;(2)观察组恢复期血清心肌酶水平比急性期降低,差异有统计学意义(P<0.01);(3)观察组心电图异常以ST-T波改变为主要表现,与对照组比较差异有统计学意义(P<0.05);(4)各民族组患儿的心肌酶水平动态变化组间比较差异无统计学意义(P>0.05)。结论:(1)高浓度胆红素可导致新生儿心肌酶及心电图异常改变。(2)高胆红素血症对心肌的损害须综合心肌酶学及心电改变进行判断。
Objective: To understand the enzymatic and electrocardiographic changes of neonates with hyperbilirubinemia and myocardial injury in Gelao, Zhuang and Han Chinese in this area. Methods: Ninety children with hyperbilirubinaemia (observation group) and 54 children with physiological jaundice (control group) were selected from three nationalities of Mulao, Zhuang and Han nationality in the same period. The bilirubin Level and myocardial enzyme changes in the relationship between the ECG and dynamic monitoring. Results: (1) The CK, CK-MB and LDH levels in the observation group were significantly different from those in the control group (P <0.05 or 0.01) (P <0.01). (3) The electrocardiogram abnormality in the observation group was mainly changed by ST-T wave, which was significantly different from the control group (P < 0.05). (4) There was no significant difference between groups in the dynamic changes of myocardial enzymes in all ethnic groups (P> 0.05). Conclusion: (1) High concentrations of bilirubin can lead to abnormal changes of myocardial enzymes and ECG in neonates. (2) hyperbilirubinemia damage to the heart muscle enzymes and ECG changes to be judged.