目的 分析新生儿窒息与血乳酸和心肌酶水平的相关性,为新生儿窒息的早期诊断与治疗提供依据。方法 选取2014年 6月-2017年6月在仙桃市第一人民医院产科出生的足月新生儿80例。以出生时轻度窒息入住新生儿重症监护室的新生儿为轻度窒息组(19例),以出生时重度窒息入住新生儿重症监护室的新生儿为重度窒息组(21例),以儿童保健科体检的足月健康新生儿为对照组40例;比较三组新生儿出生后1 h内及24 h的血乳酸和心肌酶水平,其中包含血清天门冬氨酸氨基转移酶(AST)、乳酸脱氢酶(LDH)、肌酸激酶(CK)、肌酸激酶同工酶(CK-MB)。结果 轻度窒息组和重度窒息组新生儿出生1 h和24 h内心肌酶水平和乳酸水平均显著高于对照组(P＜0.05或＜0.01),重度窒息组新生儿出生1 h和24 h的血乳酸和心肌酶水平显著高于轻度窒息组(P＜0.01)。结论 新生儿窒息会造成心肌损伤,且重度窒息造成的心肌损伤更加严重。血乳酸和心肌酶水平检测有助于临床诊断新生儿窒息和判断窒息严重程度,临床上应该进一步推广应用。

Objective To analyze the correlation of neonatal asphyxia with blood lactic acid and myocardial enzyme levels, in order to provide reference for early diagnosis and treatment of neonatal asphyxia. Methods A total of 80 full-term neonates were selected in Xiantao First People's Hospital Affiliated to Changjiang University from June, 2014 to June, 2017, and were divided into mild asphyxia group(n=19)due to mild asphyxia,severe asphyxia group(n=21) due to severe dsphyxia and control group(n=40).Serum lactate and myocardial enzyme levels, including serum aspartate aminotransferase (AST), lactate dehydrogenase (LDH), creatine kinase (CK), creatine kinase isoenzyme (CK-MB), were tested and compared within 1 hour and 24 hours after birth among three groups. Results Serum lactate and myocardial enzyme levels in 1 hour and 24 hours after birth in mild asphyxia group and severe asphyxia group were significantly higher those in control group(P＜0.05 or <0.01), which were also markedly higher in severe asphyxia group than that in mild asphyxia group(P＜0.01). Conclusions Neonatal asphyxia can cause myocardial injury, and severe asphyxia will lead to more serious myocardial injury.Test of blood lactic acid and myocardial enzyme levels can help the clinical determination of key indicators for neonatal asphyxia and the severity of the initial diagnosis, which is conducive to the diagnosis and treatment of neonatal asphyxia, and is worthy of being widely applied.