脐带血联合动脉血pH值对新生儿缺血缺氧性脑病的预测价值  

The Predictive Value of Combining Umbilical Arterial and Radial Arterial pH for Neonatal Hypoxic Ischemic Encephalopathy

作　　者：郭晓辉 李华英 夏俊霞 沙文琼 陈淑芳 

机构地区：[1]暨南大学第二临床医学院,深圳市人民医院,广东深圳518020

出　　处：《中国医科大学学报》2011年第8期738-740,共3页Journal of China Medical University

基　　金：深圳市科技计划项目(201003027)

摘　　要：目的探讨脐带血联合动脉血pH值对新生儿缺血缺氧性脑病(HIE)的预测价值。方法选取2009年4月至2011年1月在深圳市人民医院分娩的无严重畸形的7 456例活产婴儿作为研究对象,对其脐动脉血pH值与新生儿缺血缺氧性脑病的相关性进行分析,并随机选择481例新生儿于出生后1 h行桡动脉血气分析。结果 7 456例脐动脉血pH为7.10～7.42。以脐带血pH<7.10为指标预测新生儿HIE的阳性预测值为35.57%,敏感性42.06%。脐带血联合出生后1 h动脉血pH值预测HIE的敏感性为60.00%,阳性预测值71.79%。联合检测与单项检测临床符合率比较,差异有统计学意义(P<0.01)。结论脐带血pH<7.10且出生1 h动脉血pH<7.3对新生儿缺血缺氧性脑病有预测意义。脐动脉血pH<7.10的新生儿应常规于出生后复查桡动脉血pH值。Objective To study the predictive value of combining radial arterial blood and umbilical arterial blood gas analysis for hypoxic ischemic encephalopathy（HIE）.Methods 7 456 neonates without severe deformity,born in Shenzhen People′s Hospital from April 2009 to January 2011,were recruited into our research.The correlation between umbilical arterial blood gas analysis and neonatal hypoxic ischemic encephalopathy were analyzed.481 cases were randomly selected for radial arterial blood gas analysis an hour after birth.Results The pH values of umbilical arterial blood ranged from 7.10 to 7.42.There was a significant correlation between HIE and the pH value of umbilical arterial blood（P 〈 0.05）.Taken pH〈7.10 as an indicator to assess neonatal HIE,the positive predictive value and sensitivity were 35.5% and 42.06%,respectively.The positive predictive value and sensitivity of combining radial arterial with umbilical arterial blood gas analysis were 71.79% and 60.00%,respectively.The difference in clinical coincidence rates between combined test and single test was statistically significant（P 〈 0.01）.Conclusion Umbilical arterial blood pH〈7.10 and radial arterial blood（1 h after birth） pH 〈7.3 have predictive value for neonatal hypoxic ischemic encephalopathy.Radial arterial blood gas analysis should be done routinely in neonates with umbilical arterial blood pH〈7.10.

关 键 词：脐动脉 桡动脉 PH值 缺血缺氧性脑病 

分 类 号：R722.1[医药卫生—儿科]