Diagnostic value of serum cardiac troponin-I and creatine kinase isoenzyme for myocardial damage in neonates with hypoxic-ischemic encephalopathy.

Objective To investigate the diagnostic value of serusm cardiac troponin-I(cTn-I),creatine kinase(CK),creatine kinase isoenzyme(CK-MB) and CK-MB/CK ratios for myocardial damage in neonates with hypoxic-ischemic encephalopathy(HIE).Methods From August 2001 to December 2003,87 neonates with HIE and 26 neonates without HIE(control group) were enrolled in the study.Blood sample were drawn between the hiours of 8 and 24 after birth. Serum cTn-I,CK and CK-MK were tested by Fast Solid Immuno-chromatography,NAC-immunosuppression and NAC methed,respectively.Results Neonates with HIE were divided into 3 groups according to the severity of HIE.There were significant differences in serum cTn-I,CK and CK-MK levels among 4 groups(P0.05),but CK-MB/CK ratios were not.Three neonates with severe HIE had paroxysmal ventricular tachycardia and serum cTn-I125ng/L;but serum CK-MB levels were only slightly elevated without statstical significances.In a proportion of neonates with mild HIE without clinical evidence of hypoxic-ischemic myocardial damage,serum CK-MB and CK levels(but not serum CTn-I levels) were abnormally elevated.Conclusion Serum CTn-I level is more sensitive and specific than CK-MB and CK to hypoxic-ischemic myocardial damage.CK-MB/CK should not be used as a diagnostic indicator of hypoxic-ischemic myocardial damage.