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Clinical Efficiency of Cardiac Troponin T for Myocardial Damage in Neonatal Asphyxia

Journal of the Korean Pediatric Society 1999;42(2):195-202.
Published online February 15, 1999.
Clinical Efficiency of Cardiac Troponin T for Myocardial Damage in Neonatal Asphyxia
Nam Soo Kang1, Jae Kyun Yoon1, Chang Sung Son1, Joo Won Lee1, Young Chang Tokgo1, Sang Hee Kim2
1Department of Pediatrics, College of Medicine, Korea University, Seoul, Korea
2Department of Pediatrics, Gacheon College of Medicine, Chung-Ang Gil Hospital, Incheon, Korea
신생아 가사시 심근 손상에 대한 Cardiac Troponin T의 임상적 효용성
강남수1, 윤재균1, 손창성1, 이주원1, 독고영창1, 김상희2
1고려대학교 의과대학 소아과학교실
2가천의과대학 소아과학교실
Abstract
Purpose
: The aim of this study was to evaluate the clinical efficiency of cardiac troponin T (cTnT) in detecting myocardial damage in neonatal asphyxia and to compare the diagnostic value of cTnT with creatine kinase MB(CK-MB).
Methods
: Sixty-three neonates were enrolled in this study, consisting of 27 asphyxiated infants (asphyxiated group; 1-min or 5-min Apgar score≤6) and 36 healthy infants(control group). The two groups were divided to 4 subgroups as follows; group Ⅰ(17 preterm asphyxiated neonates), group Ⅱ(10 full-term asphyxiated neonates), group Ⅲ(16 preterm healthy neonates), group Ⅳ(20 full-term healthy neonates). Serum cTnT was measured within 24 hours, at 24-47 hours, and 48-72 hours after birth, respectively. Serum CK-MB was measured within 24 hours after birth.
Results
: 1) cTnT within 24 hours in asphyxiated group was significantly higher than in the control group(P<0.05). 2) cTnT in group Ⅱ was not significantly higher than in group Ⅰ(P>0.05), whereas CK-MB in group Ⅱ it was higher than in group Ⅰ(P<0.001). Between group Ⅲ and Ⅳ, cTnT and CK-MB showed significant differences(P<0.05). 3) cTnT did not change with gestational age or birthweight. CK-MB was correlated to birthweight and gestational age (Fig. 1, 2). 4) Twelve asphyxiated infants had at least one abnormal cTnT(>0.2μg/L). Ten of them(83%) had a tricuspid insufficiency of moderate or severe degree.
Conclusion
: cTnT is a more heart-specific serodiagnostic marker than other markers in asphyxiated neonates with suspected myocardial damage.
Key Words: Neonatal asphyxia, Cardiac troponin T, Myocardial damage


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