The Expression And Clinical Significance Of Highly Sensitive Cardiac Troponin â…  In Apnoea Neonatorum With Myocardial Injury

Objective:This study aims to further explore the changes of hs-cTnI and its clinical significance in neonatal asphyxia with myocardial injury, to explore the significance of changes in the occurrence and development of neonatal disease process, such as the sensitivity, specificity, sensitivity and predictive value of diagnosis. Also analyzed its correlation between various perinatal factors and disease, explore its clinical value in neonatal asphyxia with myocardial injury.Methods:79 cases of newborn were randomly selected, of which 51 cases of asphyxia as the observation group and 28 cases of normal newborns as control group. In the observation group,21 cases that diagnosed with myocardial damage as a myocardial injury group,14 males and 7 females; the remaining 30 cases without myocardial injury as a non-cardiac injury group,17 males and 13 females. After the patients admitted to the hospital, the observation group were drawn 2mL femoral vein in the acute stage (within 24h after birth) and convalescence (days 7-10d); the control group drawn 2mL femoral vein within 24h after birth. We used the chemiluminescence immunoassay for detection of hs-cTnI, myoglobin, myocardial enzymes, plasma brain natriuretic peptide level in serum, while there Apgar score, electrocardiogram, echocardiography, chest X-ray examination and other tests.Results:①The hs-cTnI levels in serum of myocardial injury group in the acute stage was significantly higher than non-cardiac injury and the control group (P<0.01), non-cardiac injury group and the control group showed no significant difference (P>0.01).②The hs-cTnI, BNP levels of severe asphyxia group were significantly higher than that of mild asphyxia group and control group, the difference has statistical significance (P<0.01), no significant difference between mild asphyxia group and control group (P>0.01). ④The level of hs-cTnl in serum was significantly decreased at comparison between myocardial injury in the convalescent and acute stage, there was significant difference between two groups(P<0.05).④The sensitivity of hs-cTnI, Mb, BNP, CK-MB in the diagnosis of myocardial injury were 85.7%,57.1%,81%,95.2%.The sensitivity of hs-cTnI is better than Mb (χ2=4.2, P<0.05). No statistically significant difference in comparison with BNP and CK-MB (χ2=0.171,1.105,P>0.05). Specificity of hs-cTnl, Mb, BNP, CK-MB in diagnosis of myocardial injury were 56.7%,50%,30%,3.3%. This indicates that hs-cTnI is better than BNP and CK-MB (χ2=4.344、20.317,P<0.05), and after comparative analysis found no significant difference with Mb (χ2=0.268, P>0.05).⑤Hs-cTnl in serum was negatively correlated with the Apgar score (r=-0.392, P<0.005), also positively correlated with the degree of asphyxia (r=0.420,P<0.05) and the extent of myocardial injury (r=-0.345,.P<0.05). It was no significant correlation with gender, amniotic fluid, production, gestational age, placenta, birth weight and umbilical cord (P>0.05).Conclusions:Hs-cTnI level in serum increased significantly which neonatal asphyxia complicated with myocardial injury was in acute stage, and is closely related to the severity of asphyxia, suggesting that hs-cTnI levels in serum were higher when the degree of asphyxia more severe. Apgar scores were correlated with hs-cTnI levels in serum, suggesting that the degree of asphyxia related to myocardial damage. So, hs-cTnI can be used as an early ideal diagnostic marker of asphyxiation with myocardial injury. Early detection of hs-cTnI levels in serum is helpful to determine whether neonatal asphyxia complicated with myocardial injury and the severity of asphyxia.