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Vojnosanitetski pregled
2009, vol. 66, br. 11, str. 881-886
jezik rada: srpski
vrsta rada: originalan članak
objavljeno: 24/11/2009
doi: 10.2298/VSP0911881S
Srčani troponin kao biohemijski pokazatelj perinatalne asfiksije i hipoksičke lezije miokarda
aKlinički centar Kragujevac, Klinika za pedijatriju
bUniverzitet u Kragujevcu, Medicinski fakultet

e-adresa: aleksandra.simovic@yahoo.com

Sažetak

Uvod/Cilj. Postasfiktička lezija miokarda kod novorođene dece može biti klinički neprimetna. Poslednjih godina raste interesovanje za primenu srčanog troponina I (cTnI), u proceni perinatalne asfiksije i hipoksičke lezije miokarda. Cilj ove studije bio je da se utvrdi povezanost ranog porasta nivoa cTnI sa krajnjim ishodom kod vitalno ugrožene asfiktične novorođenčadi. Metode. Prospektivnom studijom bilo je obuhvaćeno 78 ispitanika podeljenih u III grupe. Grupa I obuhvatala je 39 novorođenčadi (24 prevremeno rođenih i 15 u terminu) sa dijagnozom perinatalne asfiksije i kompletnim oporavkom ili sa neurološkim sekvelama, ali bez smrtnog ishoda. Grupa II obuhvatala je 10 novorođenčadi (6 prevremeno rođenih i 4 u terminu) sa dijagnozom perinatalne asfiksije praćene teškom kardiorespiratornom insuficijencijom ili multiorganskom disfunkcijom (3 ili više organa) i obaveznim smrtnim ishodom. Grupa III obuhvatala je 29 zdrave, terminske novorođenčadi. Svim ispitanicima određen je nivo cTnI u serumu tokom prva 24-48 h po rođenju. Rezultati. U grupi I zabeležena je statistički znatno viša srednja vrednost cTnI (0,082 ± 0,166 μg/l) u odnosu na grupu III (zdrava novorođenčad). U grupi I primenu inotropa zahtevalo je 16/39, a primenu konvencionalne ventilacije 21/39 novorođenčadi. U grupi II zabeležena je najviša srednja vrednost cTnI od 0,425 ± 0,307 μg/L, a svi ispitanici zahtevali su primenu konvencionalne ventilacije i inotropa. U grupi III zabeležena je najniža srednja vrednost cTnI (0,0186 ± 0,0286 μg/L). Zaključak. Porast nivoa cTnI u serumu mogao bi da se koristi kao marker perinatalne asfiksije i prediktor eventualnih posledica i/ili smrtnog ishoda.

Ključne reči

troponin I; miokard+ ishemija; novorođenče, asfiksija

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