动脉血乳酸评估窒息新生儿脑损伤的临床价值  

Clinical value of arterial blood lactic acid in evaluating brain injury in asphyxia neonates

作　　者：王燕青[1] 王永芹[2] 赵月华[2] 朱海玲[2] 杜玥瑾 陈曦 牛霞[2] WANG Yanqing;WANG Yongqin;ZHAO Yuehua;ZHU Hailing;DU Yuejin;CHEN Xi;NIU Xia(Department of Pediatrics,Weifang Medical University,Weifang 261053,China;Department of Pediatrics,the Affiliated Hospital of Weifang Medical University)

机构地区：[1]潍坊医学院儿科学教研室,山东潍坊261053 [2]潍坊医学院附属医院儿科

出　　处：《潍坊医学院学报》2019年第3期198-200,206,共4页Acta Academiae Medicinae Weifang

摘　　要：目的探讨动脉血乳酸判定因窒息导致新生儿脑损伤的临床价值,为早期干预窒息新生儿脑损伤提供临床依据。方法选取2016年12月~2018年11月在潍坊医学院附属医院住院治疗的65例有新生儿窒息史的足月儿为实验对象。在生后2h内、24h、48h、72h分别测定两组的动脉血乳酸,并应用受试者工作特征曲线(ROC curve)分析在窒息新生儿脑损伤的临床评估价值。65例患儿均于生后4~7d行头颅磁共振检查,以头颅磁共振结果为诊断脑损伤的标准,分为窒息无脑损伤组(n=30)及窒息脑损伤组(n=35),窒息脑损伤组包括新生儿缺氧缺血性脑病,颅内出血,其余为无脑损伤组。结果窒息脑损伤组中动脉血乳酸明显高于窒息无脑损伤组(P<0.05),且2h动脉血乳酸评估脑损伤的诊断价值最高,临界值为7.09mmol/L,敏感度为0.74,特异度为0.85。结论窒息脑损伤新生儿动脉血乳酸水平明显升高,早期动脉血乳酸水平可评估窒息新生儿脑损伤。Objective To explore the clinical value of Arterial blood lactic acid in the diagnosis of neonatal brain injury caused by asphyxia,and to provide a theoretical basis for early intervention of asphyxia neonatal brain injury.Methods From December 2016 to November 2018,65 term infants with history of neonatal asphyxia were selected.The arterial blood lactic acid and perfusion index were measured within 2 hours,24 hours,48 hours and 72 hours after birth.The clinical evaluation value of the two indicators in the brain injury of asphyxia neonates was analyzed by using the operating characteristic curve(ROC curve).The cranial magnetic resonance examination was performed on 65 cases of asphyxia neonates during 4 to 7 days after birth,and the results of cranial magnetic resonance imaging were taken as the criteria for the diagnosis of brain injury.The patients were divided into asphyxiated non-brain injury group(n=30) and asphyxiated brain injury group(n=35).The asphyxiated brain injury group included neonatal hypoxic-ischemic encephalopathy,intracranial hemorrhage,and apart from these were defined as asphyxiated brain injury group.Results The arterial blood lactic acid in asphyxiated brain injury group was significantly higher than that in asphyxia without brain injury group(P<0.05),and the critical value of arterial blood lactate in 2 h was 7.09 mmol/L,the sensitivity was 0.74,the specificity was 0.85.Conclusion The level of arterial blood lactate will be increased significantly in asphyxiated neonates with brain injury.Early level of arterial blood lactate to evaluate the neonatal asphyxia brain injury.

关 键 词：新生儿 窒息 脑损伤 动脉血乳酸 

分 类 号：R722.1[医药卫生—儿科]