目的:探讨血浆N端脑利钠肽前体(NT-proBNP)水平对窒息新生儿心肌损害及心功能的预测价值.方法:2010年7月～2011年3月在我院住院的30例窒息新生儿,其中,轻度窒息组18例,重度窒息组12例,对照组为同期在我院出生的30例正常新生儿.产后72 h内静脉采血测定血浆肌酸激酶同工酶(CK-MB)、肌钙蛋白和N端脑利钠肽前体,心脏彩色多普勒测定左心室射血分数.结果:①对照组、轻度窒息组和重度窒息组CK-MB分别为(15.0±5.2)U/L、(107.7±38.48)U/L和(278.3±88.12)U/L;肌钙蛋白分别为(21.82±5.67)ng/L、(77.25±28.91)ng/L和(233.75±67.02)ng/L;NT-proBNP分别为(1 909.1±430.83)pg/ml、(6 334.4±525.39)pg/ml和(10 036.2±2 039.80)pg/ml;左心射血分数分别为(0.71±0.04)、(0.46±0.06)和(0.32±0.06).各组间比较差异均有统计学意义(均P<0.000 1).②NT-proBNP与左室射血分数的相关系数r为-0.962 14,P<0.000 1.结论:N端脑利钠肽前体是反映窒息新生儿心肌损害及心功能的敏感指标.%Objective: To study the predictive value of N-terminal pro-brain natriuretic peptide on myocardial damage and cardiac function in newborns with asphyxia.Methods: The experiment group included 30 newborns with asphyxia (18 cases with mild asphyxia and 12 cases with severe asphyxia) who were in hospital from July 2010 to March 2011, and the control group included 30 normal newborns during the same period.The blood were drawn intravenously 72 hours after birthing to assay serous creatine kinase-MB (CK-MB), troponin and NT-proBNP, left ventricular ejection fraction (LVED was measured by Color Doppler.Results: ①CK-MB in the control group, the mild asphyxia group and severe asphyxia group were (15.0±5.2) U/L, (107.7±38.48) U/L and (278.3±88.12) U/L respectively; Troponin were (21.82±5.67) ng/L,(77.25±28.91) ng/L and (233.75±67.02) ng/L respectively; NT-proBNP were (1 909.1 ±430.83) pg/ml, (6 334.4±525.39) pg/ml and (10 036.2±2 039.80) pg/ml respectively; LVEF were (0.71±0.04), (0.46±0.06) and (0.32±0.06) respectively.There were all significant differences in each group (all P＜0.000 1).②The correlation coefficient (r) between NT-proBNP and LVEF were -0.962 14, P＜0.000 1.Conclusion: NT-proBNP is a sensitive indicator of myocardial damage and cardiac function in the newborns with asphyxia.
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