| Significance of Creatine Kinase Isoenzymes for Neurologic Outcome in Perinatal Asphyxia |
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Mi Kyung Son, Eun Sik Kang, Sun Hi Jung, Kyuchul Choeh |
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Department of Pediatrics, Eulji General Hospital, Taejon, Korea |
| 신생아 가사의 신경학적 예후에 관한 Creatine Kinase Isoenzyme의 의의 |
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손미경, 강은식, 정순이, 최규철 |
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대전을지병원 소아과 |
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| Abstract |
Purpose
: To investigate the usefulness of the serum Creatine kinase(CK), especially brain
typical creatine kinase(CK-BB) as an indicator of brain damage extent, mortality and long term
nurologic sequelae, the study was done.
Methods
: CK and CK isoenzyme activites were measured at 6-10 hours after birth in 160
asphyxiated newborn infants who admitted in Eulji General Hospital from August 1990 to July
1994. Infants were followed up for 1 years after birth to evaluate survival and neurologic
outcome.
Results
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1) There was low correlation between CK-BB and 5 minute Apgar score(r=0.245, p=0.0026).
2) There was intermediate correlation between CK-BB and Lactic dehydrogenase (LDH)
(r=0.470, p<0.0001).
3) Infants who died within 24 hours after birth had significantly higher CK-BB activity(144.9¡¾
98.5U/L) than survivors(82.2¡¾159U/L), (p=0.0160). Infants who died within 72 hours after birth
had significantly higher CK-BB activity(130.2¡¾108.4U/L) than survivors(80.5¡¾161.1U/L), (p=
0.0209)
4) Infants who died within 24 hours after birth had significantly higher CK-BB%(23.4¡¾17.4%)
than survivors(9.6¡¾11.9%), (p=0.0042). Infants who died within 72 hours after birth had
significantly higher CK-BB%(20.0¡¾15.4%) than survivors(9.3¡¾11.8%), (p= 0.0027). Infants who
died within 28 days after birth had significantly higher CK-BB% (12.7¡¾13.4%) than survivors
(9.7¡¾12.3%), (p=0.0500).
5) In the cases of neonatal seizure in 24-48 hours after birth, CK-BB was higher than in the
cases of no seizure or seizure in 48 hours after birth.
6) CK-BB was well correlated to the grade of hypoxic ischemic encephalopathy.
7) CK-BB, CK-BB% and 5 minute Apgar score showed similar positive and negative
predictive values for survival rate, abnormal findings of imaging studies and neurologic outcomes.
Conclusion
: CK-BB is a good predictive value for the death within 24 and 72 hours after
birth and the neonatal seizure in 24-48 hours after birth. CK-BB% is a good predictive value of
the death within 24, 72 hours and 28 days after birth. CK-BB, CK-BB% and 5 minute Apgar
score showed similar predictivity for neurologic outcomes during 1 years after birth. |
| Key Words:
Creatine kinase(CK), Isoenzyme, CK-BB, Perinatal or birth asphyxia |
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