ABSTRACT
Resumen OBJETIVO: estructurar una pregunta clínica para conocer la utilidad de la prueba cualitativa de GPBB en sangre capilar de pacientes embarazadas, con la finalidad de establecer el diagnóstico de preeclampsia. MATERIALES Y MÉTODOS: estudio ambispectivo efectuado con base en las respuestas a la pregunta clínica estructurada: ¿cuál es la validez diagnóstica de la prueba cualitativa de la isoenzima BB de la fosforilasa de glucógeno (GPBB) en sangre capilar para preeclampsia? se buscaron las fuentes primarias en PubMed, mediante las palabras clave (MeSH): "Glycogen phosphorylase isoenzyme BB AND Pregnancy" y "Glycogen phosphorylase isoenzyme BB AND Pre-eclampsia". Se seleccionaron los artículos más relevantes, se les asignó nivel de evidencia, se investigó si la muestra y metodología fueron iguales, comparables o diferentes de la prueba cualitativa en sangre capilar, y se analizaron sus resultados con la finalidad de establecer el diagnóstico clínico de preeclampsia. RESULTADOS: no se encontraron estudios de la determinación cualitativa de GPBB en sangre capilar. En tres ensayos de casos y controles (nivel de evidencia 4) se compararon las concentraciones de GPBB en suero mediante ELISA y se encontraron cifras elevadas al momento de establecer el diagnóstico clínico; sin embargo, se consideró como un rasgo fenotípico de preeclampsia clínica, pero no como una prueba diagnóstica. CONCLUSIONES: no existe suficiente evidencia médica que respalde la utilidad de la determinación cualitativa de GPBB en sangre capilar de pacientes embarazadas para establecer el diagnóstico de preeclampsia; por lo tanto, no se sustenta su aplicación en ningún escenario clínico.
Abstract OBJECTIVE: To establish if the clinical use of the test for the diagnosis of pre-eclampsia is scientifically supported by evidence-based medicine. MATERIALS AND METHODS: Ambispective study based on the responses to the PICO clinical question was constructed, then primary sources were searched in PubMed by the strategies Glycogen phosphorylase isoenzyme BB AND Pregnancy, and Glycogen phosphorylase isoenzyme BB AND pre-eclampsia, the relevant ones were selected, with allocation of level of evidence, determining if samples and methodology were similar, comparable or different to the capillary blood test, and results were analized under diagnosis clinical intention. RESULTS: No studies were found on qualitative GPBB detection in capillary blood. Three case-control studies (evidence level 4) compared GPBB maternal serum levels determined by ELISA, and described an elevation of GPBB at clinical diagnosis, rather as a phenotypical feature of clinical Pre-eclampsia, but not a diagnostic test. CONCLUSIONS: There is no evidence at all to offer the qualitative determination of GPBB in capillary blood of pregnant women; its clinical use is not supported whatsoever.
ABSTRACT
Objective To explore the clinical significance of early biomarkers in neonatal asphyxia diagnosis with myocardial damage by detection of ischemia modified albumin in neonatal serum(IMA) and glycogen phosphorylase isoenzyme BB(GPBB) for screening sensitive markers with direct myocardial injury.Methods 166 neonates were selected in our hospital as the research object,in which 136 cases with myocardial injury dividend into the experimental group and 30 cases into the control group.The experimental group were divided into mild group and severe group according to the degree of asphyxia.All the children were tested for GPBB and IMA 1 h after admission.Results The levels of GPBB in neonatal asphyxia myocardial injury group and severe asphyxia group were significantly higher than those in the control group,the difference was statistically significant(P<0.05).The sensitivity of GPBB in diagnosis of asphyxia was higher than that of IMA,the difference was statistically significant(P<0.05).Conclusion The degree of asphyxia is closely related to serum IMA,GPBB level in neonatal asphyxia complicated with myocardial injury.The sensitivity and specificity of GPBB in diagnosis asphyxia is better than IMA in children complicated with myocardial damage.