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Troponina I, creatina-fosfocinasa y creatina-fosfocinasa-MB en recién nacidos con sospecha de asfixia neonatal / Troponin I, creatine-phosphokinase and creatine-phosphokinase-MB in newborns with suspected neonatal asphyxia

Elba Nelly Cano-Vázquez, Guelmi Guadalupe Canto-Pacheco, Celia Valdez-Cabrera, Saray Castro-Betancourt, Marianne Gisselle Monroy-Azuara, Graciela Sideny Arciga-Vázquez, Socorro Méndez-Martínez

Resumen


 Resumen

Introducción: La troponina I (cTnI), la creatina-fosfocinasa (CPK) y la creatina-fosfocinasa-MB (CPK-MB) son biomarcadores cardiacos usados en neonatos con asfixia.

Objetivo: Analizar la relación entre las concentraciones de cTnI, CPK y CPK-MB con los criterios diagnósticos clínicos y bioquímicos de asfixia neonatal.

Métodos: Estudio analítico transversal en neonatos con al menos un criterio diagnóstico de asfixia. Se analizó la relación entre los niveles de cTnI y CPK-MB al nacimiento, niveles séricos de CPK y CPK-MB determinados 24 horas después del parto, con acidosis metabólica, prueba de Apgar a los 5 minutos con puntajes de 0-3, alteraciones neurológicas y/o falla orgánica múltiple.

Resultados: De 34 recién nacidos, el 73.5% nacieron vía cesárea, el 71% eran a término con un peso promedio de 3,096 ± 453 g, en los prematuros el peso fue de 2,275 ± 509 g, y la puntuación de Apgar a los 5 minutos fue de 7.77 ± 1.481 y 7.03  ±  1.705, respectivamente. El 17.6% de los neonatos tuvieron un pH < 7.20, el 58% un déficit de base < 12 mmol/l, el 5.8% Apgar < 3 a los 5 minutos y el 38.23% alteraciones neurológicas o falla orgánica múltiple. El 100% de los recién  nacidos tuvieron unos valores de cTnI normales. La CPK y la CPK-MB a las 24 horas se encontraron alteradas en un 29% con uno o dos criterios de asfixia. El porcentaje de CPK-MB se asoció con la edad gestacional.

Conclusiones: La cTnI fue normal en los neonatos con sospecha de asfixia, pero no así la CPK y la CPK-MB, que pueden elevarse en estos pacientes, principalmente en los nacidos pretérmino. Los marcadores bioquímicos no se asociaron con ninguno de los parámetros clínicos.

 

Abstract

Background: The cardiac troponin I (cTnI), creatine phospokinase (CPK), and creatine kinase- myocardial band (CK-MB) are cardiac biomarkers used in newborns with asphyxia.

Objective: To analyze the relationship between cTnI, CPK and CPK-MB levels with clinical and biochemical diagnostic criteria for neonatal asphyxia.

Methods: Analytical cross-sectional study in neonates with at least one diagnostic criterion of asphyxia. Relationship among cTnI and CPK-MB levels at birth, serum levels of CPK and CPK-MB determined 24 hours after delivery, with metabolic acidosis, Apgar test at 5 minutes with scores of 0-3, neurological alterations and/or multiple organ failure were analyzed.

Results: Thirty-four neonates, 73.5% born by cesarean section, 71% term neonates with a mean weight of 3,096 ± 453g, 2,275  ±  509g for preterm, and a mean of 7.77  ±  1.481 and 7.03 ± 1.705 5-minute Apgar score, respectively. 17.6% of the neonates reported a pH value < 7.20, 58% a base deficit of 12 mmol/L, 5.8% obtained a 5-minute Apgar score < 3, and 38.23% had neurological alterations and/or multiple organ dysfunction syndrome. All patients reported cTnI within the normal reference range. CPK and CPK-MB values, 24 hours after delivery, were elevated in 29% of the cases with one or two diagnostic criteria for neonatal asphyxia. The percentage of CPK-MB was associated with gestational age.

Conclusions: cTnI values were normal in suspected cases of neonatal asphyxia, whereas CPK and CPK MB can elevate in these population, principally in preterm newborns. Biochemical markers were not associated with any clinical parameter.

 


Palabras clave


Asfixia Neonatal; Troponina I; Recién Nacido; Creatina Quinasa; Forma MB de la Creatina-Quinasa / Asphyxia Neonatorum; Troponin I; Infant, Newborn; Creatine Kinase; Creatine Kinase, MB Form

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DOI: https://doi.org/10.24875/RMIMSS.M20000100

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