【摘要】 目的:探讨羊水渗透浓度及乳酸水平在胎儿窘迫诊断中的价值。方法:以2001年5月～2004年4月诊断为胎儿窘迫的患者228例作为研究对象,所有病例均行羊水渗透浓度、乳酸浓度及新生儿脐动脉血pH值测定。以新生儿脐动脉血pH值≤7.2为标准,比较羊水渗透浓度、乳酸浓度及传统胎心监护异常对胎儿窘迫的诊断价值。结果:NST结合OCT/CST诊断胎儿窘迫的灵敏度和特异度分别为42.59%、31.67%;羊水渗透浓度的灵敏度和特异度分别为96.30%、80.39%;羊水乳酸浓度诊断胎儿窘迫的灵敏度和特异度分别为90.74%、76.67%;两者结合诊断胎儿窘迫的灵敏度为98.15%,特异度为90.00%;三者均明显优越于胎心监护诊断胎儿窘迫的价值(P<0.01)。结论:羊水渗透浓度和乳酸浓度对胎儿窘迫有较高的诊断价值,有望成为判断胎儿缺氧的一项有效、简便、无创的生化指标。更多还原

【Abstract】 Objective:To explore the value of amniotic fluid osmotic concentration and lactate level in diagnosis of fetal distress.Methods:228 cases diagnosed as fetal distress from May 2001 to April 2004 were included in the study.All the cases received amniotic fluid osmotic concentration,lactate level and pH value detection in neonatal umbilical artery,pH value≤7.2 was used as standard,the diagnostic values of amniotic fluid osmotic concentration,lactate level and traditional fetal heart monitoring were compared.Results:The sensitivity and specificity of NST combined with OCT/CST in diagnosis of fetal distress were 42.59% and 31.67%,respectively; the sensitivity and specificity of amniotic fluid osmotic concentration were 96.30% and 80.39%,respectively; the sensitivity and specificity of lactate level in amniotic fluid were 90.74% and 76.67%,respectively; the sensitivity and specificity of amniotic fluid osmotic concentration and lactate level were 98.15% and 90.00%,respectively; the diagnostic value of amniotic fluid osmotic concentration,lactate level and joint detection of amniotic fluid osmotic concentration and lactate level were superior to that of traditional fetal heart monitoring (P<0.01).Conclusion:Amniotic fluid osmotic concentration and lactate level have high diagnostic value for fetal distress,which can be used as an effective,convenient and non-invasive biochemical indicator.更多还原