缺氧缺血性脑病预后与脐动脉血乳酸水平等关系研究

目的探讨脐动脉血乳酸水平、阿氏评分、新生儿行为神经评分(NBNA)对新生儿缺氧缺血性脑病(HIE)预后判断的价值及临床意义。方法自2003年6月在我院产科出生的窒息新生儿,娩出后在第一声啼哭前立即抽取脐动脉血2ml送检乳酸,其中64例发生HIE的患儿按病情分为轻、中、重3组,第3天及第7天进行NBNA评分,随访至4岁行C-WYCSI智力测验,统计学方法分析上述临床资料。另选同期出生的80例正常新生儿为脐动脉血乳酸值正常对照组。结果各HIE组脐动脉血乳酸值较正常新生儿组均明显升高,脐动脉血乳酸值、阿氏评分、NBNA评分与C-WYCSI测验结果及四者之间均呈直线相关关系。结论脐动脉血乳酸水平能早期预测HIE的严重程度及预后,结合阿氏评分、HIE分度、NBNA评分动态观察结果,更有助于判定HIE患儿的预后。

Hypoxic ischemic encephalopathy prognosis and umbilical arterial blood lactate levels and other relations research

Objective To explore the umbilical arterial blood lactate levels, Apgar score, neonatal be- havioral neurological assessment （NBNA） on neonatal hypoxic-ischemic encephalopathy （HIE） The prognostic value and clinical significance. Methods From June 2003 in our hospital obstetric born asphyxiated newborns af- ter delivery, immediately before the first tone crying extract umbilical arterial blood the 2 ml inspection lactate, 64 cases of HIE were divided into mild disease, into three groups, the first 3 days and 7 days the NBNA score, fol- low-up to the 4-year-old line C-WYCSI intelligence tests, the statistical method of analysis of clinical data. Elect was born in the same period 80 cases of normal newborn umbilical arterial blood lactate values in normal control group. Results HIE group, umbilical arterial blood lactate values than normal neonate group were significantly higher, umbilical arterial blood lactate values, Apgar scores, the NBNA scores and test results of C-WYCSI and four showed a straight line betweencorrelation. Conclusion The umbilical arterial blood lactate levels in the early prediction of severity of HIE and prognosis, combined with the A＇s score, HIE degree, the NBNA score dynamic observations, but also helps determine the prognosis of HIE.