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目的:探讨脑钠肽(BNP)与心肌酶(CK-MB)的动态变化在新生儿缺氧缺血性脑病中(HIE)的临床指导意义。方法:按照病情的轻重程度,分别设立对照组(健康新生儿)、轻度HIE组、中重度HIE组3组,每组30例,观察不同时期各组新生儿BNP与CK-MB浓度情况。结果:经统计学检验,7 d内3组间BNP、CK-MB浓度比较,差异有统计学意义(P<0.05);中重度HIE组较轻度HIE组的BNP、CK-MB浓度高,差异具有统计学意义(P<0.05);治疗7～14 d,轻度HIE组、中重度HIE组两组患儿BNP浓度均较治疗前(<7 d)下降(P<0.05),但结果与对照组健康新生儿比较仍处于较高水平;轻度HIE组、中重度HIE组患儿治疗7～14 d CK-MB浓度较治疗前(<7d)比较,差异有统计学意义(P<0.05)。结论:动态监测HIE患儿脑钠肽与心肌酶生化指标的变化情况,能有效评诂HIE患儿心肌损害程度和心功能情况,反映该病的严重程度,对疾病的预后有预测和指导意义。
Objective: To investigate the clinical significance of the dynamic changes of brain natriuretic peptide (BNP) and myocardial enzymes (CK-MB) in neonatal hypoxic-ischemic encephalopathy (HIE). Methods: The control group (healthy newborn), mild HIE group and moderate and severe HIE group were divided into 3 groups (30 in each group) according to the severity of the disease. The BNP and CK-MB levels in different groups were observed. Results: The levels of BNP and CK-MB in the three groups after 7 days were significantly different (P <0.05). The levels of BNP and CK-MB in the moderate and severe HIE group were higher than those in the mild HIE group (P <0.05). From 7 to 14 days after treatment, BNP levels in both mild HIE group and moderate and severe HIE group were significantly lower than those before treatment (<7 d) (P <0.05), but the difference was statistically significant CK-MB in mild HIE group and moderate-severe HIE group was significantly higher than that before treatment (<7d) (P < 0.05). Conclusion: The dynamic changes of brain natriuretic peptide and myocardial enzymes in children with HIE can effectively evaluate the degree of myocardial damage and cardiac function in children with HIE, reflecting the severity of the disease and predicting the prognosis of the disease .