【目的】 探讨缺氧性肺动脉高压(hypoxic pulmonary hypertension, HPH) 新生儿血清心肌酶谱的变化及其意义。 【方法】 对30例HPH患儿及30例胎龄、体重与HPH组相近的非HPH患儿(对照组)于生后第1、7天检测血清心肌酶谱,彩色多普勒超声心动图测定肺动脉收缩压(pulmonary artery systolic pressure, PASP),作血气分析记录血氧分压(PaO₂)。 【结果】 1)与对照组相比生后第1天:HPH组患儿PaO₂降低,PASP升高(均P<0.05);血清心肌酶谱增高(P<0.05),血清CK-MB与PaO₂、PASP呈负、正相关(P<0.05);2)与对照组相比生后第7 d:HPH组新生儿PaO₂、PASP及血清心肌酶谱恢复正常;血清CK-MB与PaO₂、PASP均无相关关系(P>0.05)。 【结论】 HPH可导致新生儿心肌损害,心肌损伤时血清心肌酶谱升高,且与血氧分压及PASP有一定的相关性。检测血清心肌酶谱有助于临床早期诊治缺氧性肺动脉高压新生儿心肌损害。

【Objective】 To study the changes and clinical value of the serum myocardial enzymes in neonates with hypoxic pulmonary hypertension(HPH). 【Methods】 There were totally 30 cases of neonates as HPH group and 30 cases of neonates as control group enrolled. Tests were performed on the 1^st and 7^th day after birth separately, which included the level of serum myocardial enzymes, pulmonary artery systolic pressure(PASP) by using the color Doppler echocardiography and blood gas analysis tested by the femoral arterial blood at the same time. 【Results】 1)There were significant differences(P<0.05) of the values of PaO₂, PASP between the HPH group and the control group on the 1st day, while there were no significant difference(P>0.05) on the 7th day. There was a negative relation between the PaO₂ and PASP(P<0.05)on the 1^st day in the HPH groups, but there was no relation between PaO₂ and PASP(P>0.05)on the 7^th day in the HPH group. 2)The level of serum myocardial enzymes obviously increased and had a significant difference in the HPH group between the control group(P<0.05) on the 1^st day, however, the result had no significance statistically on the 7^th day. The values of creatine kinase myocardial myoglobin isoenzyme(CK-MB) had significant difference(P<0.05) on the 1^st day in the HPH group. It had a positive relation among the level of serum creatine kinase myocardial myoglobin isoenzyme and PASP(P<0.05), but it had no relation among the level of blood serum myocardial enzymes and PASP(P>0.05)on the 7^th day between the HPH group and the control group. 【Conclusions】 Hypoxic pulmonary hypertension can result in myocardial damage in the neonates, and the level of myocardial enzymes will increase when myocardium are damaged. They are correlative with PaO₂ and PASP.With the improvement of hypoxia and decrease of PASP, the level of blood serum myocardial enzymes will also decrease. So the level of blood serum myocardial enzymes can reflect the myocardial damage in the neonatal hypoxic pulmonary hypertension, they provide an evidence for early diagnosis and treatment of the myocardial damage in the neonatal hypoxic pulmonary hypertension.