早产儿血清表皮生长因子测定的临床意义

目的：表皮生长因子与胎儿器官发育和功能成熟密切相关,该研究探讨早产儿窒息及早产儿坏死性小肠结肠炎患儿血清中表皮生长因子含量及其临床意义。方法：采用放射免疫方法检测10例足月新生儿和35例早产儿生后血清表皮生长因子浓度。结果：35～37周和28～34周早产儿血清表皮生长因子含量0.617±0.22μg/L,0.540±0.31μg/L明显低于足月新生儿0.723±0.18μg/L,差异有显著性(P<0.01);窒息早产儿与足月儿相比血清表皮生长因子水平降低更为明显0.446±0.24μg/Lvs0.723±0.18μg/L;坏死性小肠结肠炎早产儿与足月儿比较血清表皮生长因子浓度没有明显降低0.771±0.44μg/Lvs0.723±0.18μg/L,差异无显著性。结论：血清表皮生长因子水平与胎龄有关;窒息可使表皮生长因子水平降低。     

新生儿血清瘦素水平与生长发育关系研究

目的：探讨新生儿血清瘦素与生长发育的关系。方法：采用放射免疫法检测80例新生儿静脉血和脐血瘦素水平,其中66例足月儿分为大于胎龄儿(LGA)组18例,适于胎龄儿(AGA)组32例,小于胎龄儿(SGA)组16例。采用Rohrer’s指数=出生体重(g)×100/身长(cm)~3估测新生儿营养状态。结果：早产儿血清瘦素水平明显低于足月儿[(0.66±1.03)ng/ml vs(3.59±2.16)ng/ml],P<0.01;足月儿中AGA血清瘦素水平[(3.06±0.96)ng/ml]明显低于LGA[(4.03±2.22)ng/ml],而高于SGA[(1.13±1.98)ng/ml];足月新生儿血清瘦素水平与Rohrer’s指数、新生儿体重、胎龄呈显著正相关(r=0.61,0.68,0.62,P均<0.01)。结论：新生儿体内瘦素是反映新生儿的发育和营养状态的有用指标。[中国当代儿科杂志,2003,5(1):29-30]     

早产儿血清维生素E浓度测定

目的　测定早产儿维生素E的二种异构体α 生育酚和γ 生育酚的血清浓度,探讨早产儿体内维 生素E的水平。方法　选取早产儿、正常足月儿各16例,采用库仑阵列电化学法检测血清中维生素E水平。结果 与正常足月儿对比,早产儿血清α 生育酚浓度(217±120ng/mLvs411±284ng/mL)和γ 生育酚浓度(889±460 ng/mLvs2177±1031ng/mL)明显降低,差异有显著性意义(均P<0.05)。结论　早产儿体内维生素E储藏量相 对较少,容易发生维生素E缺乏。早产儿出生后应及时补充维生素E。     

脐血心钠素在监测高危新生儿水钠平衡中的意义

目的：心钠素(ANP)是一种具有多种功能的内分泌激素,其过度分泌可造成低钠血症。该文探讨脐血ANP测定在监测高危新生儿水钠平衡中的作用和临床意义。方法：选择117例高危新生儿依据Apgar评分的不同分为两大组,即单纯窒息组及评分正常组。单纯窒息组又分为轻度窒息组和重度窒息组,评分正常组又分为感染组和非感染组,另设40例正常新生儿为对照组。各组均在新生儿娩出后立即抽取脐血,应用放射免疫法测定ANP水平,同时抽取静脉血测定患儿的血清钠含量,并分别与对照组比较。结果：高危新生儿的脐血ANP水平明显高于正常新生儿,尤以早产儿1.46±0.39 ng/mL、严重感染新生儿1.16±0.35 ng/mL及重度窒息新生儿2.12±0.46 ng/mL增高最为明显(P<0.01)。而与其相对应的则是血清钠水平的下降,两者呈显著负相关。结论：高危新生儿脐血心钠素增高明显,易致低钠血症,早期测定可对新生儿抢救与治疗起到指导作用。     

胰岛素样生长因子-1在新生儿高胆红素血症中的变化及意义

目的：胰岛素样生长因子-1(IGF-1)是神经系统必需的调节因子,目前少有报道其与高胆红素血症之间的关系。该文主要通过测定高胆红素血症（高胆）新生儿血清中IGF-1水平及新生儿神经行为评分(NBNA)来探讨IGF-1与高胆的关系及其临床意义。方法：应用电化学发光分析法检测57例高胆新生儿和 25例正常新生儿血清中IGF-1 浓度,同步测定血清总胆红素(TSB)、未结合胆红素(USB)及白蛋白(ALB)含量,计算USB与ALB比值(B/A),并行新生儿 NBNA 评分。高胆组按血清TSB值221~256 μmol/L,257~342 μmol/L,＞342 μmol/L分为轻、中、重三组;对照组TSB ＜85 μmol/L。结果：轻、中、重高胆患儿血清IGF-1浓度均值分别为39.38±8.42,30.77±4.65,26.34±2.05 ng/L,较对照组50.16±15.73 ng/ L明显降低,在轻、中、重高胆组间IGF-1浓度差异存在显著性(P＜0.01),其值随着胆红素的升高而降低;轻、中、重高胆组NBNA评分均值分别为35.01±2.26,32.45±2.74,26.77±5.02,明显低于对照组38.24±0.78(P＜0.01),高胆各组间差异也有显著性(P＜0.01);血清IGF-1 浓度与NBNA评分呈正相关(r=0.603, P＜0.01),与B/A值呈负相关(r=-0.483, P＜0.01)。结论：高胆患儿血清IGF-1浓度显著降低,降低程度与血清胆红素水平有关;IGF-1可能与新生儿胆红素脑损伤密切相关。［中国当代儿科杂志,2009,11（5）：357-360］     

早产儿和足月儿脐血及母亲静脉血硒含量的比较

目的：硒是一种人体必需的微量元素,在细胞抗氧化防御系统中发挥着主要的作用。在早期早产儿中,低水平的硒会增加诸如慢性新生儿肺疾病、早产儿视网膜病等并发症的发生。该研究旨在检测并比较早产儿和足月儿脐血及母亲静脉血硒含量。方法：选取2008年3~7月间30个足月儿（胎龄>37 周）和30个早产儿（胎龄< 34 周）及他们的母亲作为研究对象。用原子吸收光谱法测定脐血和母亲静脉血的硒含量。结果：足月儿的脐血硒平均含量高于早产儿,差异有非常显著性(124.80± 13.72 μg/L vs 100.30 ± 11.72 μg/L, P=0.0001) 。 足月儿母亲与早产儿母亲的的平均硒含量差异无显著性 (117.03±17.15 μg/L vs 110.56±17.49 μg/L, P=0.15)。将所有婴儿的资料一起分析时,发现脐血硒含量与胎龄和出生体重显著正相关(r=0.66, P<0.0001;r=0.59, P<0.0001)。60例婴儿母亲中,无一例的血硒含量低于正常参考值的下限（70.0 μg/L）。将所有婴儿及其母亲的资料一起分析时,发现母亲血硒含量与其婴儿脐血硒含量呈显著正相关 (r=0.40, P<0.001)。结论：在伊斯法罕地区,孕母的血硒水平处于一个良好的状态,血硒水平不是早产的预测指标。足月儿的脐血硒含量高于早产儿,但足月儿和早产儿的脐血硒含量均在正常参考范围。［中国当代儿科杂志,2009,11（7）：513-516］     

碳氧血红蛋白测定对新生儿黄疸诊断的价值

目的：探讨碳氧血红蛋白测定在新生儿黄疸诊断中的临床价值。方法：189例新生儿黄疸患儿(新生儿溶血病75例,感染52例,颅内出血32例,晚发母乳黄疸30例)及142例对照组患儿同步测定动脉化毛细血管血碳氧血红蛋白(COHb)和血清总胆红素(STB);溶血组予大剂量静脉免疫球蛋白治疗后测定COHb及STB,应用SAS6.12统计软件进行处理。结果：溶血组COHb及STB分别为(3.64±0.83)%,330.84±77.15μmol/L,显著高于对照组的(2.38±0.35)%和130.18±32.86μmol/L(P<0.01);颅内出血组COHb及STB分别为(2.48±0.53)%,184.15±29.35μmol/L,高于对照组的(2.24±0.32)%及112.11±17.45μmol/L(P<0.05);感染及母乳黄疸组STB分别为286.71±45.66μmol/L,299.15±44.14μmol/L,显著高于对照组146.23±31.26μmol/L及57.33±7.83μmol/L(P<0.01),而COHb为(2.36±0.50)%及(1.84±0.49)%与对照组(2.20±0.39)%及(1.67±0.43)%比较,差异无显著性(P>0.05)。溶血性高间胆组STB低于非溶血性高间胆组(P<0.01),而COHb显著高于后者(P<0.01)。溶血组大剂量静脉免疫球蛋白治疗前后COHb分别为(3.64±0.83)%及(2.68±0.51)%,STB分别为330.84±77.15μmol/L及230.18±42.96μmol/L,治疗前后比较差异有显著性(P<0.01)。结论：COHb测定可作为胆红素产量的指标,有助于新生儿黄疸病因诊断及指导治疗。     

新生儿缺氧缺血性脑病血清神经元特异性烯醇酶和肿瘤坏死因子水平的变化

目的：观察新生儿缺氧缺血性脑病(HIE)时血清神经元特异性烯醇酶(NSE)和肿瘤坏死因子(TNF)水平的变化。方法：分别用酶联免疫法和放射免疫法检测15例足月正常新生儿(对照组)及25例足月HIE新生儿(HIE组)在生后24h内、3d和7～10d血清NSE和TNF水平。结果：HIE组在生后24h内、3d和7～ 10d的血清NSE浓度分别为(13.93± 2.71) μg/L ,(12.46±2.36 )μg/L和(8.41± 1.44 )μg/L ,对照组NSE浓度分别为(8.04±1.53)μg/L,(7.92±1.73) μg/L和 (7.56±1.02 )μg/L ;HIE组血清TNF浓度分别为(0 .401±0.183)μg/L ,(0.339±0.126)μg/L和(0.183±0.076) μg/L ,对照组TNF浓度分别为(0 .170± 0.085) μg/L ,(0 .179± 0 .116 ) μg/L和 (0 .16 5± 0 .0 5 2 ) μg/L。HIE组在生后 3d内血清NSE水平和TNF水平均显著高于正常对照组 (P <0 .0 1) ,7～ 10d与正常对照组无显著差异 (P>0.05 )。结论：NSE和TNF参与了新生儿HIE的病理生理过程。     

新生儿窒息血浆神经肽Y和神经元特异性烯醇化酶的变化及临床意义

目的　近年来神经肽在成人心脑血管疾病中的作用日益受到重视 ,但在新生儿窒息中的作用报道较少。该文探讨新生儿窒息血浆神经肽Y(NPY)和神经元特异性烯醇化酶 (NSE)的变化及临床意义。方法　选择窒息新生儿 34例 ,其中轻度窒息 18例 ,重度窒息 16例及正常对照组 14例 ,采用放射免疫法测定血浆NPY ,采用酶联免疫法测定血清NSE。结果　窒息新生儿NPY ,NSE水平均高于正常对照组 ,差异有显著性 (P <0 .0 1)。轻度窒息组与重度窒息组NPY为 16 6 .6 2± 15 .71ng L ,182 .4 1± 17.5 8ng L ;NSE为 16 .0 2± 1.93μg L,18.39±1.4 2 μg L。两组比较差异亦有显著性 (P <0 .0 1,P <0 .0 5 )。并且NPY与NSE呈正相关 (r =0 .6 5 5 ,P <0 .0 1)。结论　窒息新生儿NPY和NSE水平均显著升高 ,其水平高低与窒息程度密切相关 ,可作为判断新生儿窒息的参考指标之一。     

IL-4IL-5及IgE在儿童咳嗽变异性哮喘中的价值

目的：咳嗽变异性哮喘(CVA)是一种与气道炎症相关的疾病,有研究表明IL-4,IL-5与IgE的产生有相关性,而且与哮喘的形成有关,因此推测IL-4,IL-5在CVA发病中起重要作用。该文旨在观察IL-4,IL-5及IgE在咳嗽变异性哮喘中的诊断价值。方法：用酶联免疫吸附实验(ELISA法)检测咳嗽变异性哮喘患儿、哮喘急性发作期患儿、正常同龄儿童各30例外周血单个核细胞(PBMC)内IL-4,IL-5及血清IgE水平。结果：①咳嗽变异性哮喘患儿发作期PBMCIL-4为91.57±12.19ng/L、IL-5为13.28±0.31ng/mL,显著高于缓解期的74.68±11.54ng/L,6.53±0.28ng/mL及正常对照组70.32±18.16ng/L,5.29±0.36ng/mL,(均P<0.01),但缓解期及正常对照组间差异无统计学意义;②咳嗽变异性哮喘发作期患儿血清IgE水平为279.6±41.3KU/L,显著高于缓解期153.8±37.5KU/L,两组均显著高于正常对照组的90.6±44.8KU/L,(均P<0.01);③咳嗽变异性哮喘患儿发作期IL-4,IL-5及IgE水平与哮喘患儿发作期的92.21±3.12ng/L,15.11±1.37ng/mL,287.5±41.9KU/L之间相比差异无统计学意义。结论：联合检测单个核细胞内IL-4,IL-5及血清IgE水平对咳嗽变异性哮喘的诊断有重要价值;IL-4,IL-5可能在咳嗽变异性哮喘的发病机制中起重要作用;咳嗽变异性哮喘可能存在与哮喘相同的发病机制,是典型哮喘的前驱表现。     

窒息新生儿脑干听觉诱发电位与血清神经元特异性烯醇化酶的相关性分析

目的：通过研究窒息患儿脑干听觉诱发电位（BAEP）异常与神经元特异性烯醇化酶（NSE）的相关性,探讨NSE对早期了解窒息患儿听神经损害的临床意义和应用前景。方法：选择该院窒息足月新生儿52例作为研究组,根据Apgar评分以及是否合并缺氧缺血性脑病(HIE)分为单纯轻度窒息组23例、单纯重度窒息组15例和窒息合并HIE组14例。采用双盲试验在生后7 d同一时间检测BAEP和NSE,初次BAEP检测异常者在生后3个月同一时间进行第2次BAEP和NSE检测。正常足月新生儿30例作为对照组。结果：窒息患儿两次听力损伤检出率分别为50.0%,21.2%。BAEP两次检出异常率,重度窒息组(63.3%,26.3%)与轻度窒息组(36.9%,5.9%)比较,差异均有显著性意义(P<0.05),HIE组(57.1%,31.3%)与重度窒息组比较差异无显著性意义。各研究组NSE水平均明显高于对照组(P<0.01),重度窒息组为26.70±2.34 μg/L明显高于轻度窒息组的17.18±3.16 μg/L,差异有显著性意义(P<0.01),HIE组为27.00±2.01 μg/L,与重度窒息组比较差异无显著性意义。BAEP异常组NSE水平为25.69±4.12 μg/L高于BAEP正常组的17.15±3.09 μg/L(P<0.01),NSE水平随着V波反应阈值的增高而增高(P<0.05)。结论：血清NSE水平与BAEP密切相关,可作为早期评估窒息患儿听神经损害和判断预后的指标之一。     

窒息新生儿血清促生长激素释放多肽与超敏C反应蛋白水平动态变化及临床意义

目的探讨窒息新生儿血清促生长激素释放多肽(Ghrelin)及超敏C反应蛋白(hs-CRP)水平的动态变化。方法选择我院产科2010年4月至2011年6月分娩的轻度、重度窒息新生儿各40例为观察组,检测脐血、急性期(1～3天)及恢复期(7～10天)血清Ghrelin和hs-CRP水平;选择同期住院无窒息史的健康新生儿40例为对照组,检测脐血Ghrelin和hs-CRP水平。结果窒息组Ghrelin水平随病程变化先降后升,急性期[(22.1±8.8)ng/ml]与恢复期[(33.2±12.2)ng/ml]均低于脐血[(38.0±13.2)ng/ml],恢复期高于急性期,差异有统计学意义(P<0.05)。对照组脐血Ghrelin水平[(72.3±15.6)mg/ml]明显高于窒息组,轻度窒息组脐血、急性期、恢复期Ghrelin水平高于重度窒息组。窒息组hs-CRP水平随病程变化先升后降,急性期[(0.48±0.22)mg/L]高于脐血[(0.14±0.11)mg/L],恢复期[(0.12±0.09)mg/L]低于急性期,差异有统计学意义(P<0.05)。对照组脐血hs-CRP水平[(0.02±0.00)mg/L]低于窒息组;轻度窒息组急性期低于重度窒息组,脐血和恢复期与重度窒息组比较差异无统计学意义。结论 Ghrelin、hs-CRP水平与窒息的发生、发展有关,窒息新生儿脐血、恢复期血清中Ghrelin变化比Hs-CRP更能反应窒息严重程度。     

Plasma homocysteine levels and folate status in children with sickle cell anemia.

PURPOSE: A sensitive inverse relationship between plasma homocysteine concentration and folate status has been demonstrated. Although children with sickle cell anemia (SCA) are at potential risk for folate deficiency, plasma homocysteine levels have not been reported in such patients. Therefore, a study was designed to assess plasma homocysteine levels as a marker of folate status. DESIGN: Plasma homocysteine concentrations were measured in 120 children with SCA (102 in steady state and 18 during an acute complication) who had never received supplemental folic acid. Folate status was directly assessed in 34 of these patients. RESULTS: Plasma homocysteine levels in the patients with SCA and control subjects were similar. The mean value +/- 1 SD was 5.8+/-2.5 micromol/L (range, 1.6 to 14.1 micromol/L) in the patients with SCA and 6.1+/-2.7 micromol/L (range, 1.7 to 15.3 micromol/L) in 73 pediatric control subjects. In a subpopulation of the study group (34 children), simultaneous serum folate, red cell folate, and total homocysteine concentrations were also measured. Their serum folate and red cell folate concentrations were normal: 12.4+/-10.0 nmol/L (range, 1 to 42 nmol/L) and 604+/-374.7 nmol/L (range, 205 to 1741 nmol/L), respectively. There was no correlation of plasma homocysteine concentration with various clinical or laboratory measures or with red cell folate concentration. CONCLUSION: Folate stores in children with SCA not receiving folic acid supplements are adequate despite an underlying hemolytic anemia.     

Plasma homocysteine levels in children and adolescents with type 1 diabetes

OBJECTIVE: Hyperhomocysteinemia has been established as a risk factor for cardiovascular disease. The objective was to investigate total plasma homocysteine concentrations in children and adolescents with type 1 diabetes and a control group. METHOD: Twenty-seven children with type 1 diabetes and 27 subjects of an age- and sex-matched control group were recruited. Fasting samples were collected for plasma total homocysteine, serum vitamin B12, folate, and creatinine. RESULTS: Fasting total homocysteine concentrations showed no difference between patients and controls (5.6 +/- 2.9 micromol/L vs 5.7 +/- 2.2 micromol/L; p greater than 0.05). The diabetic patients had significantly higher serum folate than the healthy controls (11.4 +/- 3.3 ng/mL vs 9.4 +/- 4.1 ng/mL; P = 0.02 and higher serum B12 than the control group (282.8 +/- 119 pg/mL vs 228.5 +/- 50.9 pg/mL; P = 0.03). Total plasma homocysteine concentration correlated with age (r = 0.44, P = 0.02), weight (r = 0.56, P = 0.002), body mass index (r = 0.57, P = 0.002), folate (r = -0.48, P = 0.01), and creatinine (r = 0.41, P = 0.03) in diabetic patients. In stepwise multivariate regression model for diabetics, the independent correlates for total plasma homocysteine concentration was folate (P = 0.002). CONCLUSION: We concluded that fasting plasma total homocysteine concentrations were within normal limits in children and adolescents with type 1 diabetes who were without any clinical evidence of microvascular and macrovascular complications.     

新生儿HIE脐血IL-6、IL-8与TNF-α变化及临床意义探讨

为探讨新生儿缺氧缺血性脑病 ( HIE)脐血 IL - 6、IL - 8与 TNF-α的变化及临床意义 ,应用放射免疫法检测了 4 0例 HIE患儿 IL- 6、IL- 8与 TNF- α水平 ,并与 4 0例正常新生儿比较。结果显示与正常新生儿比较 ,HIE患儿与正常对照儿相比脐血IL - 6水平分别为 ( 61.0 4± 2 3 .0 6)对 ( 91.83± 3 7.5 4 ) ng/L ( P<0 .0 1) ,IL - 8分别为( 0 .3 4± 0 .0 9)对 ( 0 .2 6± 0 .0 7) μg/L( P<0 .0 1) ,TNF- α分别为 ( 1.0 3± 0 .3 0 )对 ( 0 .83± 0 .3 1) μg/L( P<0 .0 1) ;而且病情越重改变越明显。因此 ,我们认为 ,围产期窒息与HIE患儿脐血 IL - 6水平减低、IL - 8与 TNF-α水平升高有关 ;它们可能参与了新生儿缺氧缺血性脑损伤的某些发病过程     

Evaluation of lactate dehydrogenase, creatine kinase and hepatic enzymes for the retrospective diagnosis of perinatal asphyxia among sick neonates

It is difficult to make a retrospective diagnosis of perinatal asphyxia in symptomatic neonates delivered non-institutionally. We studied serum creatine kinase muscle-brain fraction (CK-MB), lactate dehydrogenase (LDH), glutamic oxaloacetic transaminase (SGOT) and glutamic pyruvate transaminase (SGPT) for differentiating asphyxiated (n=25) from non-asphyxiated (n=20) neonates who present with non-specific signs of sickness. CK-MB was assayed at 8 and 24 h; and LDH, SGOT and SGPT at 72 h of life. On comparing cases and controls, median 8-hr CK-MB [80 U/L vs. 26 U/L respectively, P< 0.001], median 24-hr CK-MB [33.5 U/L vs. 21.5 U/L respectively, P=0.009] and median LDH [965 U/L vs. 168 U/L respectively, P< 0.001] were higher in asphyxiated neonates. Raised LDH had 100% sensitivity, while CK-MB had 100% specificity for asphyxia. LDH had the highest area under ROC curve (0.998). We conclude that LDH at 72 hr of life is most accurate at differentiating asphyxiated from non-asphyxiated symptomatic neonates.     

The relationship between abdominal aortic intima-media thickness and lipid profile in neonates born to mothers with preeclampsia

Neonates born to mothers with preeclampsia are known to be associated with lipid alterations that might increase the risk for cardiovascular disease in adult life. The aim of this study was to investigate the effect of preeclampsia on lipid metabolism, aortic intimamedia thickness (aIMT) and subsequent atherogenic risk in newborn infants. Aortic intima-media thickness was measured in 60 neonates of mothers with preeclampsia (group I; 30 neonates of mothers with preeclampsia and group II; 30 neonates of mothers with severe preeclampsia) and 30 healthy neonates (group III). Maternal and cord serum lipid profiles were determined in all groups. Mean abdominal aIMT measurements were higher in the neonates born to mothers with preeclampsia (group I; 0.36 +/- 0.03 mm and group II; 0.36 +/- 0.04 mm) compared with the control group (group III; 0.33 +/- 0.03 mm, p = 0.006). Serum triglyceride levels were significantly higher in the neonates born to mothers with preeclampsia (group I; 39.2 +/- 42.0 mg/dl and group II; 39.5 +/- 56.5 mg/dl) compared with the control group (group III; 14.9 +/- 18.8 mg/dl, p = 0,039). Serum HDL cholesterol levels were significantly lower in the neonates born to mothers with preeclampsia (group I; 17.3 +/- 12.3 mg/dl and group II; 17.1 +/- 12.8 mg/dl) compared with the control group (group III; 27.6 +/- 13.0 mg/dl, p = 0.002). In conclusion; neonates of mothers with preeclampsia have significantly higher aIMT with lipid alterations. This may play a role in the pathogenesis of atherosclerosis in adult life.     

Effect of birth asphyxia on serum calcium levels in neonates

Serum calcium and phosphorus levels were measured at birth, 6 hours, 24 hours, and on 5th day of life in 35 neonates with birth asphyxia (one-minute Apgar score of 6 or less), and in 37 neonates without asphyxia (one-minute Apgar score of 7 or more). Infants were divided into three groups: FT-AGA (n=30, asphyxia=15), FT-IUGR (n=20, asphyxia=10) and PT-AGA (n=22, asphyxia=10). Asphyxiated infants-FT-AGA as well as FT-IUGR-had significantly lower serum calcium levels than control infants during each of the time period studied. In PT-AGA infants with asphyxia, the serum calcium was significantly low only on 5th day of life. Lack of calcium intake, and hyperphosphatemia were identified as possible risk factors for low serum calcium in asphyxiated infants. No change in serum calcium levels was found in bicarbonatetreated asphyxiated infants in comparison to those who did not receive sodium bicarbonate. In view of the high incidence of low serum calcium in asphyxiated infants, serial monitoring of serum calcium levels is recommended in these infants.     

窒息新生儿脐血乳酸值的临床意义(英文)

目的：Apgar评分和血气分析作为判断新生儿窒息程度和预后的指标有一定的局限性,为寻找更具敏感性和特异性的指标,该研究探讨脐血乳酸值在新生儿窒息中的临床意义。方法：对31例足月窒息新生儿(分为轻度窒息组22例和重度窒息组9例)和30例正常新生儿(对照组)的脐动脉血进行乳酸测定及微量血液气体分析,并在第14天进行新生儿20项行为神经测定(NBNA)。结果：轻、重度窒息组脐动脉血乳酸值［(6.42±0.14) mmol/L,(10.77±0.12) mmol/L］较对照组［(4.20±0.15) mmol/L］显著升高(P<0.01),pH值［(7.16±0.07),(7.04±0.09)］较对照组(7.18±0.11)明显降低(P<0.01);其中重度窒息组的乳酸值高于轻度窒息组,pH值低于轻度窒息组,差异均有显著性(P<0.01)。脐血乳酸值与pH值及第14天NBNA评分呈显著负相关(r=-0.76,-0.85,P<0.01)。结论：脐血乳酸值可作为判断新生儿窒息程度和近期预后的指标。