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【目的】探讨窒息足月儿出生后24 h内血乳酸水平与血糖浓度的动态改变及其临床意义。【方法】259例围生期窒息足月新生儿根据1 min Apgar评分分为轻度窒息组(4~7分)、重度窒息组(0~3分)和宫内窘迫组(8~10分),18例健康足月新生儿为对照组,分别于出生后1、62、4 h采集外周动脉血测定血乳酸和血糖水平,比较各组间数据的差异及相关性。【结果】健康对照组、轻度窒息组、重度窒息组及宫内窘迫组患儿在出生后1、6、24 h的血糖水平差异无统计学意义;生后1 h和6 h时间点重度窒息组血乳酸水平高于其它组,差异有统计学意义(P<0.05)。出生后1 h,Apgar评分越高则血乳酸值越低,两者之间中度相关(R2=0.454,P<0.05)。【结论】血糖水平对于评估足月新生儿窒息严重程度的临床意义不明显。足月窒息新生儿出生后1日内,血乳酸水平与窒息程度之间存在相关性,早期检测血乳酸水平可作为临床判断足月新生儿窒息程度的辅助实验室指标。
【Objective】 To investigate the dynamic change of blood lactate level and blood glucose concentration within 24 hours after birth in asphyxiated term infants and its clinical significance. 【Methods】 A total of 259 neonates with perinatal asphyxia were divided into mild asphyxia group (n = 4 to 7), severe asphyxia group (n = 0 to 3) and intrauterine distress group (n = 8 to 10) ) And 18 healthy full-term newborn infants as the control group. Blood lactate and blood glucose levels were measured at 1,62 and 4 h after birth respectively. Data differences and correlations among the groups were compared. 【Results】 There was no significant difference in blood glucose level between 1, 6 and 24 h after birth in healthy control group, mild asphyxia group, severe asphyxia group and intrauterine distress group. After 1 and 6 h of birth, Asphyxia group, blood lactate levels higher than the other groups, the difference was statistically significant (P <0.05). 1 h after birth, the higher the Apgar score, the lower the blood lactate level, with a moderate correlation between them (R2 = 0.454, P <0.05). 【Conclusion】 The clinical significance of blood glucose level in assessing the severity of neonatal asphyxia is not obvious. Within one day after birth, full-term asphyxia neonates have a correlation between blood lactate levels and asphyxia. Early detection of blood lactate levels may be used as a secondary laboratory index for judging neonatal asphyxia in full-term.