The Change Of Myocardial Injury Markers And Research Of Creatine Phosphate Sodium Early Intervention In Neonatal Asphyxia

Objective: Objective:Myocardial damage after neonatal asphyxia is themost common diseases in newborns.It can affect the prognosis of neonates withasphyxia Myocardial injury markers commonly used include creatinekinase(CK), MB fraction of creatine kinase(CK-MB),lactate dehydrogenase(LDH),alpha hydroxybutyrate dehydrogenase(α-HBDH),myoglobin(Mb),troponin I(cTnI).The markers provide evidence for diagnosis,treatment andefficacy evaluation of myocardial injury due of asphyxia. Creatine phosphatesodium (CP) has widely been used in adult angina pectoris, myocardialinfarction, cardiac function disorder caused by a variety of reasons.But its usein neonates has not been very well studied.To further investigate the change ofthe myocardial injury markers in neonates with asphyxia,we study the level ofthe myocardial injury markers in neonates with asphyxia.And we investigate theclinical efficacy of creatine phosphate sodium on treating myocardial damagedue to neonatal asphyxia in this experiment.Methods:101neonates with asphyxia were divided into mild asphyxiagroup(57cases) and severe asphyxia group(44cases).The control groupincluded40neonates without asphyxia.Infants in severe asphyxia group were randomly divided into routine treatment group(n=22) and creatine phosphatesodium group(n=22).The routine treatment included conventional oxygeninhalation, respiratory support and maintaining stable internal environment andsymptomatic treatment.While in the CP group, we combined with intravenousinjection of CP in addition to the conventional treatment.CK,CK-MB,LDH,α-HBDH,Mb,cTnI in all groups were tested within the first24hours life.Besides,infants in severe asphyxia group also tested these markers at7th dayafter birth and Electrocardiogram left ventricular ejection fraction within thefirst24hours life,respectively.To observe and analysize the clinical therapitcefficancy of CP group,we observated clinical symptoms,electrocardiogram andleft ventricular ejection fraction in neonates with severe asphyxia before andafter treatment of R and CP.Results:1.The level of CK,CK-MB,LDH,α-HBDH,Mb,cTnI were higher inneonates with asphyxia than in control group,Neonates with severe asphyxiawere higher than those with mild asphyxia.2.The markers levels in the twogroups were decreased after treatment,compared with that before treatment(P<0.05),and CP group had decreased more significantly than R group(P<0.05)after the treatment.3.Neonates with severe asphyxia had all myocardial damagesymptoms,ECG abnormal rate is higher, but lower incidence of left ventricularejection fraction decrease,after7days,clinical indexes of both R group and CPgroup were significantly improved. Conclusions:1.The level of CK,CK-MB,LDH,α-HBDH,Mb,cTnI increasesin neonates with asphyxia.2. The level of CK,CK-MB,LDH,α-HBDH,Mb,cTnIincreases more obviously with the asphyxia degree aggravating.3.Thesemarkers are helpful for devaluation severity of myocardial damage caused byasphyxia.4.CP can improve myocardial damage caused by asphyxia.