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Objective:To investigate the changes in myocardial enzyme spectrum, procalcitonin, and C-reactive protein levels in neonates with hyperbilirubinemia.Methods:A total of 150 neonates with hyperbilirubinemia who received treatment in the 1 st Affiliated Hospital of Wenzhou Medical University during January-December 2019 were included in this study. They were allocated to mild (total bilirubin level 221-256.5 μmol/L, n = 68) and moderate-to-severe hyperbilirubinemia (total bilirubin level > 256.5 μmol/L, n = 82) groups according to different serum total bilirubin levels. An additional 70 healthy neonates who were born concurrently served as controls. Myocardial enzyme spectrum (creatine kinase, creatine kinase-MB, lactate dehydrogenase, alpha-hydroxybutyrate dehydrogenase), procalcitonin, and C-reactive protein levels were compared among groups. The correlation between myocardial enzyme spectrum, procalcitonin, and C-reactive protein levels and the severity of hyperbilirubinemia was investigated. The factors related to hyperbilirubinemia in neonates were analyzed using logistic regression analysis. Results:Serum levels of creatine kinase, creatine kinase-MB, lactate dehydrogenase, and alpha-hydroxybutyrate dehydrogenase were (1130.23 ± 385.42) U/L, (194.82 ± 60.33) U/L, (993.45 ± 271.46) U/L, and (493.76 ± 105.65) U/L, respectively in the moderate-to-severe hyperbilirubinemia group, which were significantly higher than those in the mild hyperbilirubinemia and control groups [(682.23 ± 258.53) U/L, (82.67 ± 24.43) U/L, (486.38 ± 112.57) U/L, (252.63 ± 38.73) U/L; (368.13 ± 104.20) U/L, (27.90 ± 8.29) U/L, (402.13 ± 102.20) U/L, (228.53 ± 34.30) U/L; F = 67.12, 56.23, 66.57, 44.34, all P < 0.01]. Serum levels of creatine kinase, creatine kinase-MB, lactate dehydrogenase, and alpha-hydroxybutyrate dehydrogenase were significantly higher in the mild hyperbilirubinemia group than those in the control group (all P < 0.05). Premature infants, intrauterine distress, neonatal asphyxia, amniotic fluid pollution, sepsis, omphalitis, erythrocyte glucose-6-phosphate dehydrogenase defect, and delayed passage of meconium are the risk factors for neonatal hyperbilirubinemia ( OR = 6.13, 5.40, 5.29, 4.26, 7.79, 6.99, 5.79, 5.44, all P < 0.05). Breastfeeding is an independent protective factor for the development of neonatal hyperbilirubinemia ( OR = 5.87, P < 0.05). Conclusion:Myocardial enzyme, procalcitonin, and C-reactive protein levels increase in neonates with hyperbilirubinemia with the aggravation of the disease. Close monitoring of high-risk factors of neonatal hyperbilirubinemia (including preterm infants, intrauterine distress, neonatal asphyxia, amniotic fluid pollution, sepsis, omphalitis, erythrocyte glucose-6-phosphate dehydrogenase defect, and delayed passage of meconium) and strengthening perinatal health care and high-risk pregnancy management can reduce the incidence of pathological jaundice.
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Objective: To explore the diagnostic value of 12 leads electrocardiogram (ECG) combined with detection of myocardial enzyme spectrum for atypical myocardial infarction. Methods: 80 patients with atypical myocardial infarction were enrolled in the observation group, and 80 patients with typical myocardial infarction in the same period were enrolled in the control group. Both of two groups were implemented the routine 12 leads ECG examination using FX-8322 ECG instrument, and the changes of Q wave and ST segment were recorded. And the series of indicators of serum myocardial enzymes (CK, CK-MB and cTnI) were detected by using AU2700 automatic biochemical analyzer. The test results of the first symptoms, ECG characteristics, myocardial enzyme spectrum and diagnostic accuracy of the two groups were compared. Results: In 80 patients of observation group, the painless first symptom was 20%, and the atypical pain was 75%, the typical upper abdominal and back pain accounted for 5%. In 80 patients of control group, all of them were typical upper abdominal and back pain, and the differences of these indicators between the two groups were significant (x2=8.889, x2=48.000, x2=72.381, P<0.05). For characteristics of ECG, the 22.5% of 80 patients of observation group hasn't been changed at ST-T segment, and the 17.5% of them was no pathological Q wave +T wave erect +ST segment elevation, and the percentage of pathological Q wave +T wave erect +ST segment elevation in observation group was 60.0%. On the other hand, the 100.0% of 80 patients of control group was pathological Q wave+T wave inverted +ST segment elevation, the differences of these indicators between the two groups were significant (x2=10.141, x2=7.671, x2=20.000, P<0.05). The results of myocardial enzyme spectrum detection indicated that the levels of serum CK, CK-MB and cTnI in the observation group were significantly lower than those in the control group (t=59.766, t=20.735, t=13.352, P<0.05), respectively. The diagnostic accuracy rate of ECG in observation group was 87.5%, which was significantly lower than 100% in control group (x2=5.333, P<0.05). The accuracy rate of ECG combined with myocardial enzyme spectrum in the observation group was 100%, which was not statistically significant compared with that in control group. Conclusion: 12 leads ECG is effective in diagnosing typical myocardial infarction, but it is necessary to combine myocardial enzyme spectrum detection for atypical myocardial infarction so as to increase the diagnostic accuracy rate.
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Objective To investigate the effect of pidotimod combined with antiviral drugs on immunologic function and myocardial enzyme spectrum in children with infectious mononucleosis.Methods 94 cases of children with infectious mononucleosis selected in Wenzhou Children's hospital were randomly divided into control group and research group,47 cases in each group.The control group were given conventional antiviral treatment; On this basis,the research group were given pidotimod,2 weeks for one period of treatment.Before and after treatment,immune function,cell factors and myocardial enzyme spectrum were tested,the clinical symptoms,signs,the curative effect and complications were observed and compared.Results Compared with before treatment,after treatment,serum CD4+,CD4+/CD8+ IgA and IgG increased,CD8+ decreased,TNF alpha,IL-6,AST,LDH,CK,CK-MB decreased(P<0.05).Compared with the control group,in the research group,CD4+,CD4+/CD8+,IgA and IgG content is higher,CD8+ content is lower,the TNF alpha,IL-6,AST,LDH,CK,CK-MB content is lower(P<0.05).The time of antipyretic,angina fade,narrow lymph nodes,liver and spleen shrinks and length of hospital stay in the research group were shorter than that in the control group(P<0.05).The effective rate was 74.47％in the control group,lower than 91.49％of research group(P<0.05).Conclusion The curative is exact that pidotimod combined with antiviral drugs on the treatment of infectious mononucleosis.It could improve immune function,reduce myocardial enzyme spectrum and inflammation.
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Objective To investigate the effects of sodium tanshinone ⅡA injection on myocardial enzymes and heart function of patients with acute myocardial infarction, and to explore its therapeutic mechanism. Methods A total of 217 patients with acute myocardial infarction in Taihe Hospital emergency department were randomly divided into control group (n=110) and the Tanshinone group (n=107). The control group was treated by thrombolysis, vascular dilation, antihypertension, anti-shock and other conventional treatment. On the basis of control group treatment, Tanshinone group added the intravenous injection 20mg sodium tanshinone injection. The ELISA was used to test serum creatine kinase (CKMB), superoxide dismutase (SOD), malondialdehyde (MDA) and cardiac troponin I (CTNI) and other enzymes indexes before and after treatment. The heart function were assessed by measuring the left ventricular patient of maximum rising/ falling rate (± LVdp/dtmax),left ventricular end-diastolic diameter (LVDD), left ventricular ejection fraction (LVEF),systolic blood pressure (SP), diastolic blood pressure (DP), pulse pressure (PP ) and heart rate (HR) and other indicators. Results After treatment, the CK-MB (10.76 ± 1.02 mmol/L vs. 15.17 ± 1.21 mmol/L, t=3.724), CTNI (0.11 ± 0.02 ng/ml vs.1.51 ± 0.05 ng/ml, t=2.570), MDA (4.54 ± 0.23 nmol/ml vs. 9.98 ± 1.37 nmol/ml, t=5.035) in the Tanshinone group were significantly lower than those in the control group (P<0.05). The SOD (452.27 ± 21.56 U/L vs. 209.50 ± 15.43 U/L, t=3.935), LVDD (50.74 ± 5.36 mm vs. 44.91 ± 5.31 mm, t=2.454) and LVEF (4.59% ± 0.17% vs. 3.64% ± 0.11%, t=4.052) in the Tanshinone group were significantly higher than those in the control group (P<0.05). The heart function of +dp/dtmax (3742 ± 162 mmHg/s vs. 3948 ± 193 mmHg/s, t=3.731), -dp/dtmax (3512 ± 135 vs. 3847 ± 181, t=3.025), PP (30.5 ± 5.3 mmHg vs. 35.8 ± 5.1 mmHg, t=2.902), DP (99.2 ± 8.8 mmHg vs. 117.3 ± 10.8 mmHg, t=4.079) in the Tanshinone group were significantly lower than those in the control group (P<0.05). The total effective rate was 98.14% (105/107), the control group was 87.2%(96/110), and there was significant difference between the 2 groups (χ2=10.417, P<0.05). Conclusions The Tanshinone ⅡA sodium injection can improve myocardial enzymes and heart function of patients with acute myocardial infarction, which refered to its protective effect on acute myocardial infarction.
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To study the comparability of myocardial enzyme spectrum detection results by two different bio-chemical testing systems to provide references for mutual accredit of detection results in one lab. Following NC-CLS document EP9-A2, 8 clinical specimens were selected every day for five days and tested for AST, LDH, CK and CK-MB respectively with Siemens ADVIA1800 and Johnson & Johnson Victro350 systems. Acknowledging Siemens AD-VIA1800 as objective testing system, the results were utilized to make correlation analysis and clinical acceptability esti-mation. There was high precision in Siemens ADVIA1800 and Johnson & Johnson Victro350 (CV≤1/3CLIA′88 allowable error). It's proved by t test that the difference of the myocardial enzyme results tested with Siemens ADVIA1800 and Johnson Victro350 was statistically significant (P0.975). In the comparison with the Siemens ADVIA1800, the standard errors (SE%) of AST, CK and CK-MB tested with Johnson Victro350 were 4.0%-6.6%, 9.6% and 13.3%, which were accepted by clinical standard; while the SE% of LDH tested with Johnson Victro350 were 11.2%-12.7%, which were beyond clinically acceptable range. In case one item is tested by different testing systems in one laboratory, the comparison and bias estimation acceptable eval-uationare necessary to judge the clinical acceptability, which can ensure the accuracy and consistency of the results.
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Objective To compare the myocardial enzyme spectrum of native mountain yaks ( Bos grunniens) , alien mountain yellow cattle ( Bos taurus domestica) and low altitude yellow cattle breeding in Qinghai plateau, explove the mechanism that the native mountain yaks adapt to the plateau environment.Methods The samples were treated by cervical bleeding to death, and whole blood was collected.Then serum were prepared from whole blood.The myocardial enzymes including aspartate amino transferase, creatine kinase, creatinine kinase-MB isoenzyme, lactate dehydrogenase, α-hydroxybutyrate dehydrogenase and.Results In the native mountain yaks and in the alien mountain yellow cattle, levels of AST, CK, CK-MB were significantly higher than those in the low altitude yellow cattle (P<0.05);compared with the alien mountain yellow cattle, levels of AST,CK were significantly higher than those in the native mountain yaks (P<0.05),CK-MB,LDH and HBDH were lower(P<0.05).The results suggested that under the high altitude and hypoxia environment, myocardial cell injury occurred in the alien mountain yellow cattle, thus various enzymes penetrated through the cells into the blood circulation, lead to the higher serum enzymatic levels.Conclusion The phenomenon indicates that the alien mountain yellow cattle is in a state of high altitude acclimatization.But the native mountain yaks are well adapte to the high altitude and hypoxia environment.
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Objective To investigate the effect of ademetionine assisted therapy on transferrin ( TRF) , myocardial enzyme spectrum and bilirubin in serum of patients with icterus neonatorum.Methods 86 cases of neonatal jaundice in the hospital were randomly divided into two groups.43 cases in control group were treated with conventional therapy, 43 cases in experimental group were treated by ademetionine.Serum transferrin, myocardial enzymes, serum total bilirubin levels and clinical effects were compared pre-treatment and post-weat ment.ResuIts Compared with control group, the TRF level of experimental group was higher (P<0.05), the level of Aspartate transaminase (AST), lactate dehydrogenase (LDH), creatine kinase (CK), and CK-MB in experimental group were lower (P<0.05), the total bile acid (TBA), total bilirubin (TBIL) and direct bilirubin (DBIL) in experimental group were lower (P<0.05).The total effective rate in experimental group was significantly higher than that in control group (χ2 =8.53, P<0.05).ConcIusion Ademetionine assisted therapy has a good clinical curative effect and could effectively reduce serum TRF, DBIL and myocardial enzyme spectrum level, which has important significance in the treatment of neonatal jaundice.
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Objective To investigate the clinical significance of the changes of hypersensitive C-reactive protein (hs-CRP) and myocardial enzyme spectrum,cardiac troponin Ⅰ (cTn Ⅰ) in patients with Henoch-Schnlein purpura.Methods 100 patients with Henoch-Schnlein purpura were selected.50 patients only skin involved were selected as the simple group,50 patients accompanied by other organs involved were selected as mixed group.50 healthy people in the same period were selected as the control group.The serum hs-CRP,myocardial enzyme spectrum and cTn Ⅰ were tested and compared.Results The hs-CRP,serum myocardial enzyme spectrum and cTn Ⅰ levels of mixed and simple group were significantly higher than the control group(all P ＜ 0.05) ; Serum CK-MB,cTn Ⅰ and hs-CRP levels of the mixed group were significantly higher than those of simple group (all P ＜ 0.05).The abnormalities number of CK-MB and cTn Ⅰ respectively accounted for 33％ (33/100) and 32％ (32/100) ;The constituent ratio of the number of abnormal serum CK-MB and cTn Ⅰ of the mixed group was significantly higher than the simple group (x2 =4.047,3.908,all P ＜ 0.05) ;The Pearson correlation analysis showed that the relationship between the serum hs-CRP and CK-MB,cTn Ⅰ levels was linear,which were positively correlated (r =0.872,0.801,all P ＜ 0.05).Conclusion Patients with allergic purpura should early detect the serum levels of hs-CRP,myocardial enzyme spectrum and cTn Ⅰ,and treat the myocardial injury in time.
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Objective To discuss the value of analysis of serum myocardial enzyme spectrum and cardiac troponin I(cTnI) in neonatal hypoxic ischemic encephalopathy(HIE) .Methods Serum level of myocardial enzyme spectrum in each people was deter-mined with Hitachi 7602 ,Serum levels of cTnI was determined by chemoluminescence method .Serum levels of myocardial enzyme spectrum and cTnI were collect from 65 neonates with HIE(HIE group) and 68 cases of helthy volunteers(control group) .Results The levels of glutamic oxalacetic transaminase(AST) ,creatine kinase(CK) ,creatine kinase MB isoenzyme(CK-MB) ,lactic dehy-drogenase(LDH) and alpha-hydroxybutyric dehydrogenase(HBDH) in HIE group were(98 .9 ± 9 .6)U/L ,(385 .4 ± 15 .5)U/L , (89 .3 ± 9 .6)U/L ,(300 .8 ± 19 .8)U/L ,(399 .1 ± 17 .9)U/L ,which were higher than those in control group(P<0 .05) .The level of cTnI was(1 .4 ± 0 .4)ng/mL in HIE group ,which was higher than that in control group(P<0 .05) .CK-MB sensitivity was 88 .6% , cTnI speciality rate was 86 .3% .Conclusion The assay of myocardial enzyme spectrum and cTnI is significant in diagnosis of neo-natal HIE .