Study On Changes Of Myocardial Enzymes Spectrum In Neonates With Severe Hyperbilirubinemia Before And After Exchange Transfusion

Objective:To investigate the changes of myocardial enzymes spectrum in neonates with severe hyperbilirubinemia before and after exchange transfusion.Methods:A total of28neonates with severe hyperbilirubinemia in conformance with the indications of exchange transfusion admitted to our hospital from January2011to December2013were selected. All the neonates were treated with exchange transfusion. And the concentration of serum total bilirubin (TBIL), indirect bilirubin (IBIL), aspartate aminotransferase (AST), lactate dehydrogenase (LDH), creatine kinase (CK), creatine kinase (CKMB) before and after exchange transfusion were detected. Then the comparisons of the changes in serum bilirubin and myocardial enzymes spectrum before and after treatment were made and statistically analyzed.Results:The levels of TBIL before and after exchange transfusion were respectively508.44±78.33umol/L and204.43±54.53umol/L, and IBIL were482.60±74.8umol/L and203.37±55.01umol/L respectively.The TBIL and IBIL levels of the selected newborns decreased obviously after the exchange transfusion, showing statistically significant difference compared with that before exchange transfusion (all P<0.05). Before exchange transfusion, the concentration of AST, LDH, CKMB, CK were68.10±32.06U/L,865.82±294.53U/L,84.67±14.29U/L,914.64±501.64U/L respectively, while after exchange transfusion, the concentration of AST, LDH, CKMB, CK were35.42±12.07U/L,268.52±128.17U/L,38.64±9.989U/L, 290.39±167.02U/L, respectively. The differences before and after exchange transfusion are statistically significant (all P<0.05). Before and after exchange transfusion of CKMB and TBIL respectively do binary variables related analysis, Pearson correlation coefficients were0.279,0.294, P values were0.043,0.041, respectively. CK-MB and TBIL were positively correlated, the difference was statistically significant.Conclusion:The hyperbilirubinemia in neonates may cause myocardial damage to a large degree. Exchange transfusion can significantly reduce serum bilirubin and myocardial enzymes spectrum levels, thereby reducing bilirubin encephalopathy and myocardial damage. In a word, exchange transfusion can improve the quality of life of Neonates with Severe Hyperbilirubinemia.