| 曹立萍,李彩霞,王冬霞,林玉贤,刘秀艳.血乳酸和心肌酶变化在胎儿宫内窘迫新生儿中的临床意义[J].,2019,19(20):3916-3919 |
| 血乳酸和心肌酶变化在胎儿宫内窘迫新生儿中的临床意义 |
| Clinical Significance of Changes of Blood Lactate and Myocardial Enzyme in Neonates with Intrauterine Distress |
| 投稿时间：2019-01-28 修订日期：2019-02-24 |
| DOI：10.13241/j.cnki.pmb.2019.20.026 |
| 中文关键词: 胎儿宫内窘迫 血乳酸 心肌酶 新生儿窒息 临床意义 |
| 英文关键词: Intrauterine distress Blood lactate Myocardial enzyme Neonatal asphyxia Clinical significance |
| 基金项目:全军医药卫生科研基金项目（14BJZ1028） |
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| 中文摘要: |
| 摘要 目的：探讨血乳酸和心肌酶变化在胎儿宫内窘迫新生儿中的临床意义。方法：选取2017年3月到2018年8月期间在我院出生的胎儿宫内窘迫新生儿120例，其中有55例出生后未出现窒息，将其纳入观察1组，另外65例新生儿出生后出现窒息则纳入观察2组，同时选取同期在我院出生的健康、足月新生儿60例作为对照组。比较三组新生儿的血乳酸、乳酸脱氢酶（LDH）、肌酸激酶（CK）、肌酸激酶同工酶MB（CKMB）、血氧分压（PaO2）、二氧化碳分压（PaCO2）的水平，并分析血乳酸与心肌酶、PaO2、PaCO2的相关性。结果：出生时、出生后5d，观察2组的血乳酸、LDH、CK、CKMB水平均高于观察1组和对照组，且观察1组的血乳酸、LDH、CK、CKMB水平均高于对照组，差异均有统计学意义（P<0.05）。出生时，观察2组的PaO2水平低于观察1组和对照组，PaCO2水平高于观察1组和对照组，差异均有统计学意义（P<0.05），观察1组的PaO2水平低于对照组，PaCO2水平高于对照组，差异均有统计学意义（P<0.05）。Pearson相关性分析结果显示，胎儿宫内窘迫新生儿血乳酸水平与CK、CKMB、PaCO2呈正相关，与PaO2呈负相关（P<0.05），与LDH无明显的相关性（P>0.05）；LDH、CK、CKMB与PaCO2呈正相关，与PaO2呈负相关（P<0.05）。结论：胎儿宫内窘迫新生儿血乳酸和心肌酶水平明显升高，且出生后存在窒息的新生儿中更为明显，胎儿宫内窘迫新生儿血乳酸、心肌酶水平与缺氧程度密切相关。 |
| 英文摘要: |
| ABSTRACT Objective: To investigate the clinical significance of blood lactate and myocardial enzyme changes in neonates with intrauterine distress. Methods: A total of 120 neonates with intrauterine distress, who were born in the Second Naval Hospital of Southern Theater Command from March 2017 to August 2018, were enrolled and were divided into two groups: observation group I(n=55, no asphyxia after birth) and observation group II(n=65, asphyxia after birth). At the same time, 60 healthy and full-term newborns born in this hospital were chosen as control group. Blood lactate, lactate dehydrogenase (LDH), creatine kinase (CK), creatine kinase isoenzyme MB (CKMB), blood oxygen partial pressure (PaO2), and carbon dioxide partial pressure (PaCO2) levels in three groups of neonates were compared. The correlation between blood lactate and myocardial enzymes, PaO2 and PaCO2 was analyzed. Results: At birth and 5 days after birth, the levels of blood lactate, LDH, CK and CKMB in observation group II were higher than those in observation group I and the control group, and the above indexes in observation group I were higher than those in control group. The differences were statistically significant (P<0.05). At birth, PaO2 level of observation group II was lower than that of observation group I and control group, but PaCO2 level was higher than that of observation group I and control group, and the differences were statistically significant (P<0.05). The PaO2 level of observation group I was lower than that of control group, but PaCO2 level was higher than that of control group, the differences were statistically significant (P<0.05). Pearson correlation analysis showed that the blood lactate level in neonates with intrauterine distress were positively correlated with CK, CKMB and PaCO2, and negatively correlated with PaO2 (P<0.05), and significantly not correlated with LDH (P>0.05). LDH, CK and CKMB were positively correlated with PaCO2, and negatively correlated with PaO2 (P<0.05). Conclusion: The levels of blood lactate and myocardial enzymes in neonates with intrauterine distress significantly increase, and this phenomenon is more pronounced in neonates with asphyxia after birth. The levels of blood lactate, myocardial enzymes in neonates with intrauterine distress are closely related to the degree of hypoxia. |
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