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Vojnosanitetski pregled
2014, vol. 71, br. 2, str. 149-155
jezik rada: engleski
vrsta rada: izvorni naučni članak
objavljeno: 11/02/2014
doi: 10.2298/VSP1402149S
Uloga biohemijskih markera kao ranih indikatora oštećenja srca i prognostičkih parametara perinatalne asfiksije
aKlinički centar Kragujevac, Klinika za pedijatriju + Univerzitet u Kragujevcu, Medicinski fakultet
bUniverzitet u Beogradu, Medicinski fakultet, Institut za zdravstvenu zaštitu majke i deteta Republike Srbije 'Dr Vukan Čupić' + Univerzitet u Beogradu, Medicinski fakultet
cUniverzitet u Beogradu, Medicinski fakultet, Institut za zdravstvenu zaštitu majke i deteta Republike Srbije 'Dr Vukan Čupić'
dKlinički centar Kragujevac, Klinika za pedijatriju

e-adresa: aleksandra.simovic@yahoo.com

Sažetak

Uvod/Cilj. Poslednjih godina u žiži interesovanja naučne javnosti je primena srčanih markera kao ranih indikatora i prognostičkih parametara perinatalne asfiksije. Cilj ovog rada bio je da se proceni značaj kliničke primene srčanih markera kod terminske novorođenčadi sa perinatalnom asfiksijom. Metode. Tokom trogodišnje studije analizirano je 91 terminsko novorođenče (55 sa i 36 bez perinatalne asfiksije). Kod svih ispitanika određivana je simultano serumska koncentracija srčanog troponina-I, moždanog natriuretskog peptida, MB frakcije kreatin kinaze i Creaktivnog proteina u prvih 24-48 h po rođenju. Rezultati. U grupi terminske novorođenčadi sa perinatalnom asfiksijom registrovan je značajno viši nivo srčanog troponina- I (p = 0,000), CK-MB frakcije (p = 0,000), moždanog natriuretskog peptida (p = 0,003) i C-reaktivnog proteina (p = 0,017), u odnosu na grupu zdrave, terminske novorođenčadi. Nivo srčanog troponina-I bio je u korelaciji sa Apgar skorom u petom minutu (r = -0,637; p = 0,000) i koncentracijom laktata u prvih 12 h po rođenju (r = 0,529; p = 0,000). Rani porast srčanog troponina-I > 0,135 μg/L ukazivao je na rizik od smrtnog ishoda, sa senzitivnošću 84,6% i specifičnošću 85,9%, dok porast CK-MB frakcije, moždanog natriuretskog peptida i C-reaktivnog proteina nije bio pouzdan prediktor mortaliteta. Zaključak. Srčani troponin-I je najsenzitivniji i jedini pouzdan prediktor mortaliteta kod terminske novorođenčadi sa perinatalnom asfiksijom.

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