title: [Clinical monitoring of myocardial injury in neonates with intrauterine distress].
abstract: OBJECTIVE
  To investigate whether no asphyxia neonates with intrauterine distress are complicated with myocardial injury and determine the sensitive biochemical diagnostic parameters.
  
  
  METHODS
  A total of 89 neonates born in the First Affiliated Hospital of Sun Yat-sen University from July 2009 to December 2009 were enrolled. Fifty-three fetal distress cases with Apgar score > 7 at 1 and 5 minutes were enrolled in the study group; while the rest 36 healthy neonates, whose Apgar score = 10 at 1 and 5 minutes, were the control group. Umbilical artery blood samples of all cases were collected for blood gas analysis and biochemical measurement.
  
  
  RESULTS
  (1) pH (7.23 ± 0.07) and BE [(-4.8 ± 3.0) mmol/L] in the study group were significantly lower than pH (7.31 ± 0.03) and BE [(-2.1 ± 1.5) mmol/L ] in the control group(P < 0.05). The lactic acid of study group [(5.2 ± 2.3) mmol/L] was higher than that of the control group [(2.3 ± 1.1) mmol/L], and the difference was significant (P < 0.01). However, there was no significant difference between the two groups in PaO2 [(16.2 ± 7.9) mm Hg (1 mm Hg = 0.133 kPa) vs. (17.5 ± 6.7) mm Hg] and PaCO2 [(54.0 ± 11.2) mm Hg vs. (48.5 ± 5.4) mm Hg; P > 0.05]. (2) The level of CK-MB in neonates with fetal distress[ (48 ± 59) U/L] was significantly higher than that of healthy neonates [(36 ± 27) U/L]. However, no significant difference was found in CK [(194 ± 73) U/L vs. (162 ± 95) U/L] and BNP levels [(519 ± 309) ng/L vs. (481 ± 216) ng/L; P > 0.05]. (3) Spearman rank correlation analysis showed that CK-MB level was negatively correlated with pH (r = -0.296, P < 0.05) and BE (r = -0.318, P < 0.05) of umbilical artery blood, while BNP level was positively correlated with umbilical lactic acid (r = 0.278, P < 0.05). No correlation was found between other parameters (P > 0.05).
  
  
  CONCLUSIONS
  Intrauterine distress without neonatal asphyxia had effect on fetal myocardial injury. CK-MB can be used as a sensitive parameter for monitoring the development of myocardial injury. The severity of myocardial injury was related to fetal acidosis.
authors.affiliation: Department of Obstetrics and Gynecology, First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, China.
authors.forename: Hai-tian
authors.initials: HT
authors.lastname: Chen
authors.forename: Zi-lian
authors.initials: ZL
authors.lastname: Wang
authors.forename: Guang-han
authors.initials: GH
authors.lastname: Wang
authors.forename: Ming-jing
authors.initials: MJ
authors.lastname: Hu
authors.forename: Wen-jing
authors.initials: WJ
authors.lastname: Zhu
mesh_terms: D000328:Adult; D001034:Apgar Score; D015415:Biomarkers / Q000097:blood; D001784:Blood Gas Analysis; D016022:Case-Control Studies; D003402:Creatine Kinase / Q000097:blood*; D052279:Creatine Kinase, MB Form / Q000097:blood*; D005260:Female; D005316:Fetal Distress / Q000150:complications*; D006335:Heart Injuries / Q000201:enzymology*; D006801:Humans; D006863:Hydrogen-Ion Concentration; D007231:Infant, Newborn; D007527:Isoenzymes / Q000097:blood; D008297:Male; D009206:Myocardium / Q000201:enzymology* / Q000473:pathology; D020097:Natriuretic Peptide, Brain / Q000097:blood; D014469:Umbilical Arteries / Q000737:chemistry*
chemical_list: D015415:Biomarkers; D007527:Isoenzymes; D020097:Natriuretic Peptide, Brain; D003402:Creatine Kinase; D052279:Creatine Kinase, MB Form