【摘要】 目的通过观察阴道分娩新生儿脐动脉血乳酸水平变化,研究脐血乳酸水平与酸中毒、新生儿结局、行为神经测定(neonatal behavioral neudogioal assessment,NBNA)间的关系。方法随机选择2005年2月至2006年3月阴道分娩的291例新生儿进行研究,分为两组,对照组174例,观察组117例,测定新生儿脐动脉血乳酸、血气分析及NBNA评分。结果对照组新生儿脐动脉血乳酸95%参考值范围为1.49mmol/L~4.15mmol/L。对照组与观察组新生儿脐动脉血乳酸水平及主要血气参数比较,差异有显著意义(P<0.01)。观察组新生儿脐血乳酸水平与pH值、BE值、生后4d~6d NBNA评分比较,差异有显著意义(r=-0.46,-0.51,-0.32;P<0.01),以乳酸浓度>4.15mmol/L为界值(x-±1.96s),诊断代谢性酸中毒(BE值<-6mmol/L),其敏感度为58.54%,特异度为90.40%。结论脐动脉血乳酸浓度与pH值、BE值有较好的相关性及相似的预测价值,是一项判断围生儿产时宫内酸碱代谢状况,评估新生儿近期预后的生化指标。更多还原

【Abstract】 Objective The correlation between umbilical cord blood lactate levels and acidosis,neonate outcome and neonatal behavioral neudogioal assessment(NBNA)was studied by measuring umbilical artery blood lactate levels neonates by vaginal delivery.Methods 291 neonates by vaginal delivery from February 2005 to March 2006 were divided into two groups,in which there were 174 cases in control group and 117 cases in observing group,and measured on their umbilical artery blood lactate levels and blood gas analysis.At the 4～6th and 26～28 th day after birth,NBNA was taken for each subject.Results The range of normal value was set as 1.49～4.15 mmol/L for the neonatal umbilical artery blood lactate levels in control group.There was a significant difference of the umbilical artery blood lactate level,pH value and BE value between control group and observing group(P<0.01).The lactate levels in observing group was significantly negatively correlated with pH,BE level and the 4~6th day after birth NBNA(r=-0.46,-0.51 and-0.32,respectively,P<0.01).A lactate value higher than 4.15 mmol/L(±1.96 s)predicted a metabolic acidosis(BE<-6 mmol/L)with a sensitivity of 58.54% and a specificity of 90.40%.Conclusions The umbilical artery blood lactate levels may be a useful index in evaluating intrapartum hypoxia,acidosis grade and short-term prognosis in neonates.更多还原