Clinical Value Of Detection Of Umbilical Cord Blood Serum NT-proBNP And Myocardial Enzymes In Neonatal Hypoxic-ischemic Encephalopathy

Objective To investigate the changes of umbilical cord blood serum N-terminal pro B-type natriuretic peptide and myocardial enzymes in neonatal hypoxic ischemic encephalopathy,to evaluate the predictive value of clinical diagnosis in neonatal HIE.Methods 20 cases of full-term healthy newborns who suffered no risk of postpartum asphyxia and perinatal asphyxia were selected as the control group.60 cases of newborns who suffered high risk of perinatal asphyxia were selected as the observation group,their gestational age ranging between 37 weeks and 42 weeks.Of the 60 cases in the observation group,54 cases who suffered from HIE belonged to HIE group while the other 6 cases belonged to non-HIE group.According to the degree of HIE,the HIE group were divided into the mild group(10cases)the moderate group(36cases)and the severe group(8cases).Observing the clinical data,electrocardiogram and cardiac ultrasound results of the two groups,detecting the diagnostic value of umbilical cord blood serum NT-pro BNP and myocardial enzymes from umblilical venous serum 4ml extracted immediately after their labor,and calculating the diagnostic value of umbilical cord blood serum NT-pro BNP and myocardial enzymes in neonatal hypoxic-ischemic encephalopathy.Results There was no statistic significance in the differences of gender,gestational age,body weight,body length and mode of delivery between the two groups(P > 0.05).Incidence of HIE in the observation group with high risk factors of perinatal asphyxia were significantly higher than that in the control group(P < 0.05).Incidence of cardiovascular system,electrocardiogram,and echocardiographic abnormalities in HIE group were significantly higher than that in the non-HIE group and control group(P < 0.05).The levels of serum NT-pro BNP in observation group were significantly higher than those in control group(P < 0.05).The levels of CK-MB,CK,LDH and AST in HIE group were significantly higher than those in non-HIE group and control group(P < 0.05).There was no significant difference in CK-MB between non-HIE group and control group(P > 0.05).Levels of Serum NT-pro BNP and serum CK-MB were positively correlated(r = 0.537,P < 0.05),Levels of both of them were positively correlated with the severity of HIE group(r1 = 0.608,r2= 0.438,P < 0.05).The area under the ROC curve of serum NT-pro BNP levels in the diagnosis of HIE is 0.954,the best diagnostic point > 1034.83 pg / ml.The area under the ROC curve of serum CK-MB levels in diagnosis of HIE is 0.925,the best diagnostic point > 42.99U/L.Through comparison of their sensitivity and specificity,serum NT-pro BNP HIE is superior to CK-M in the diagnosis of HIE.In the joint detection of serum NT-BNP and CK-MB in diagnosis of HIE,the area under the ROC curve is 0.925,specificity is 88.5% and sensitivity is 96.3%.The diagnostic value of joint detection is superior to separate detection of CK-MB,the difference is statistically significant(P < 0.05).Compared with NT-pro BNP,there was no significant difference(P > 0.05).Conclusion The levels of umbilical cord blood serum NT-pro BNP and CK-MB in neonates of HIE group were increased to different degrees.Umbilical cord blood serum NT-pro BNP,CK-MB levels can be early to reflect the severity of HIE disease;Early detection of umbilical cord blood serum NT-pro BNP,CK-MB can be an early prediction of the occurrence of HIE,effectively assess the severity of it and provide a theoretical basis for early intervention.