Journal of the Korean Pediatric Society 1998;41(5):669-676.
Published online May 15, 1998.
On the Significance of Blood Sampling Time in Neonatal Neurologic Prognosis Using Creatine Kinase BB
Heung Taek Kim, Mi Kyung Son, Eun Ju Kim, Kyuchul Choeh
Department of Pediatrics, Eulji Medical College, Taejon, Korea
신생아 신경학적 예후 판정에서 채혈 시간에 따른 Creatine Kinase BB의 의미
김흥택, 손미경, 김은주, 최규철
을지의과대학 소아과학교실
Heung Taek Kim, Email: 1
: To investigate the cut-off value of creatine kinase(CK) BB according to blood sampling time in predicting neonatal prognosis, we studied the time-related releasing pattern of CK isoenzymes after birth asphyxia.
: CK was measured within 1 hour and at 6-10 hours after birth from 45 newborn infants who were suspected to be perinatal asphyxia or fetal distress. The infants were followed up for 1 year to evaluate neonatal prognosis.
: Total CK, CK-MM, CK-BB and CK-BB% from blood samples within 1 hour after birth were 758.6U/L, 588.7U/L, 105.7U/L and 17.5%, respectively, and those at 6-10 hours after birth were 1,298.0U/L, 1,127.1U/L, 57.7U/L and 6.6%, respectively. When the cut-off value of CK-BB measured within 1 hour after birth was set to 200U/L, positive predictive value(PP) was 0.38 and negative predictive value(NP) was 0.76 for infants who died within 28 days. For neurologic sequelae on 1-year-old PP and NP are 0.33 and 0.76 respectively, for neonatal seizures, 0.38 and 0.92, for abnormal brain sonogram cases 1.0 and 0.88, repectively.
: CK-BB and CK-BB% were measured significantly higher within 1 hour after birth than at 6-10 hours after birth. Because of different CK-BB levels between 2 separate sampling times, we have to use 2 different cut-off values. It is recommended that cut-off values for CK-BB and CK-BB%, measured within 1 hour after birth, are 200U/L and 20%, respectively and cut-off values for CK-BB and CK-BB% measured in 6-10 hours after birth are 100U/L and 10%, respectively.
Key Words: Creatine kinase, Isoenzyme, Birth asphyxia, Prognosis, Sampling time

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