Uloga biohemijskih markera kao ranih indikatora oštećenja srca i prognostičkih parametara perinatalne asfiksije

  • Aleksandra M. Simović Pediatric Clinic, Clinical Centre Kragujevac, Kragujevac, Serbia; Faculty of Medicine, University of Kragujevac, Kragujevac, Serbia
  • Jovan Lj. Košutić Mother and Child Health Care Institute “Dr Vukan Čupić”, Belgrade, Serbia; Faculty of Medicine, University of Belgrade, Belgrade, Serbia
  • Sergej M. Prijić Mother and Child Health Care Institute “Dr Vukan Čupić”, Belgrade, Serbia
  • Jasmina B. Knežević Pediatric Clinic, Clinical Centre Kragujevac, Kragujevac, Serbia; Faculty of Medicine, University of Kragujevac, Kragujevac, Serbia
  • Ana J. Vujić Pediatric Clinic, Clinical Centre Kragujevac, Kragujevac, Serbia; Faculty of Medicine, University of Kragujevac, Kragujevac, Serbia
  • Nadežda D. Stojanović Pediatric Clinic, Clinical Centre Kragujevac, Kragujevac, Serbia
DOI: https://doi.org/10.2298/1780
Ključne reči: perinatology||, ||perinatologij, asphyxia||, ||gušenje, biological markers||, ||biološki pokazatelji, heart failure||, ||srce, insuficijencija, troponin I||, ||troponin I, sensitivity and specificity||, ||testovi, prognostička vrednost.,

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 C-reaktivnog 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.

Biografije autora

Aleksandra M. Simović, Pediatric Clinic, Clinical Centre Kragujevac, Kragujevac, Serbia; Faculty of Medicine, University of Kragujevac, Kragujevac, Serbia

Šef odseka izolacije odeljenja intezivne nege Centra za neonatologiju, Klinika za pedijatriju, Klinički Centar Kragujevac

Jovan Lj. Košutić, Mother and Child Health Care Institute “Dr Vukan Čupić”, Belgrade, Serbia; Faculty of Medicine, University of Belgrade, Belgrade, Serbia

Consultant paediatric cardiologist, Mother and Child Health Care Institute “Dr Vukan Cupic”, Belgrade

Associate professor of pediatrics, Faculty of Medicine, University of Belgrade

Sergej M. Prijić, Mother and Child Health Care Institute “Dr Vukan Čupić”, Belgrade, Serbia
Paediatric cardiologist, Mother and Child Health Care Institute “Dr Vukan Cupic”, Belgrade
Jasmina B. Knežević, Pediatric Clinic, Clinical Centre Kragujevac, Kragujevac, Serbia; Faculty of Medicine, University of Kragujevac, Kragujevac, Serbia

Full professor of pediatrics, Faculty of Medicine, University of Kragujevac

Chief of  Departement of cardiology, Pediatric Clinic, Clinical Centre Kragujevac, Kragujevac, Serbia

 

Ana J. Vujić, Pediatric Clinic, Clinical Centre Kragujevac, Kragujevac, Serbia; Faculty of Medicine, University of Kragujevac, Kragujevac, Serbia

Assistant professor, Faculty of Medicine, University of Kragujevac,

Pediatric Clinic, Clinical Centre Kragujevac, Kragujevac, Serbia

Nadežda D. Stojanović, Pediatric Clinic, Clinical Centre Kragujevac, Kragujevac, Serbia
Director of Centre of neonatology,Pediatric Clinic, Clinical Centre Kragujevac, Kragujevac, Serbia

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Objavljeno
2015/04/21
Broj časopisa
Vol. 71 Br. 2 (2014)
Rubrika
Originalni članak