脐血有核红细胞计数和乳酸联合预测新生儿缺氧缺血性脑损伤  

Prediction of neonatal hypoxia ischemic brain damage by nucleated erythrocyte count in umbilical cord blood combined with lactate detection

作　　者：刘昕[1] 范秀芳[1] 郝素媛[1] 毕汇文[1] 

机构地区：[1]山东省济南市妇幼保健院,250001

出　　处：《中国妇幼保健》2011年第31期4847-4849,共3页Maternal and Child Health Care of China

摘　　要：目的:探讨脐血有核红细胞计数(NRBC)和乳酸水平联合预测新生儿缺氧缺血性脑损伤(HIBD)界值,方法:选择100例有胎儿窘迫史的新生儿为研究对象,其中急性窘迫组46例,慢性窘迫组54例,包括新生儿窒息46例,发生HIBD18例,轻度10例,中重度8例;对照组45例均为济南市妇幼保健院同期正常分娩的新生儿,测定脐血NRBC和乳酸水平。结果:①HIBD组与非HIBD组比较,NRBC数量、乳酸水平差异有统计学意义(t=10.649,t’=8.904,P=0.000,p’=0.000);②中重度HIBD与轻度HIBD比较,NRBC数量、乳酸水平差异有统计学意义(t=4.614,t’=2.480,p=0.000,p’=0.025);③NRBC在15/100个白细胞中,乳酸在4.25 mmol/L水平联合预测HIBD时,敏感度为94%,特异度为96%。结论:NRBC为15/100WBC、乳酸为4.25 mmol/L可以作为预测HIBD界值。Objective：To explore the thresholds of neonatal hypoxia ischemic brain damage（HIBD） predicted by nucleated erythrocyte count in umbilical cord blood combined with lactate detection.Methods：100 neonates with the history of fetal distress were selected as study objects,including 46 neonates in acute distress group and 54 neonates in chronic distress group,46 neonates were found with neonatal asphyxia,and 18 neonates were found with HIBD（10 neonates with mild HIBD and 8 neonates with moderate to severe HIBD）;45 normal neonates were selected as control group,nucleated erythrocyte counts in umbilical cord blood and lactate levels in the two groups were detected.Results：There was significant difference in nucleated erythrocyte count in umbilical cord blood and lactate level between HIBD group and non-HIBD group（t=10.649,t＇=8.904,P=0.000,p＇=0.000）;and there was significant difference in nucleated erythrocyte count in umbilical cord blood and lactate level between moderate to severe HIBD group and mild HIBD group（t=4.614,t＇=2.480,p=0.000,p＇=0.025）;the sensibility and specificity of joint prediction of nucleated erythrocyte count in umbilical cord blood（15/100 white cells） and lactate level（4.25 mmol/L） were 94% and 96%,respectively.Conclusion：The thresholds to predict HIBD are nucleated erythrocyte count in umbilical cord blood（15/100 white cells） and lactate level（4.25 mmol/L）.

关 键 词：脐血有核红细胞 乳酸 新生儿缺氧缺血性脑损伤 

分 类 号：R722[医药卫生—儿科]