THE PREDICTIVE VALUE OF SPECIFIC SERUM ENZYMES FOR NEUROLOGIC
OUTCOME IN ASPHYXIATED NEWBORN
Kim KH1, Yoo JH1, Hong SJ2,
Kim DS2
1 NHIC Ilsan Hospital, Koyang, Korea
2 Konkuk University Hospital, Chungju, Korea
Objective: Perinatal
asphyxia is one of the most important factors contributing to neonatal
morbidity and mortality. However, no clear-cut parameters exist which
enable an early identification of neonates who are at risk to develop brain
damage.
Methods: We measured
creatinine kinase (CK), CK isoenzyme, AST (aspartate aminotransferase), ALT
(alanine aminotransferase), LDH (lactic dehydrogenase) in full term
asphyxiated (n=35) and healthy (n=39) newborns at 6-10 hours after birth to
establish the values of these enzymes in the retrospective diagnosis of
asphyxia and if serum levels of these enzymes correlated with the
abnormalities of neurosonography or auditory evoked potential.
Results: The
asphyxiated newborns had significantly increased serum activities of CK-BB
(93.5±160.8 IU/L) and CK-BB% (11.1±12.4%) compare to controls
(39.2±37.2 IU/L, 3.9±3.4%). However, there were no significant
differences in the enzyme activities between normal and abnormal groups of
neurosonography or auditory evoked potential.
Conclusion: It is
concluded that elevated CK-BB and CK-BB% are reliable indicator of the
neonatal asphyxia. But the predictive value of specific enzymes for the
development of neurologic disorders is not clear. Prospective long-term
follow up studies are necessary to evaluate the predictive value of enzyme
activities for the neurologic outcome.