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目的探讨窒息新生儿血乳酸水平与临床预后的关系。方法采用GEM Premier 3000分析仪对133例足月窒息新生儿生后1、9h动脉血乳酸水平进行测定,观察其与新生儿神经行为评分(NBNA评分)及其不良预后的关系。结果正常对照组、轻度窒息组与重度窒息组新生儿在生后1h的血乳酸水平为(3.56±0.8)mmol/L、(8.32±4.6)mmol/L和(12.13±4.4)mmol/L,P<0..01,在生后9h为(1.52±0.5)mmol/L、(3.4±1.0)mmol/L和(6.3±1.8)mmol/L,P<0.05;在生后2周的NBNA评分为(37.9±2.1)、(33.0±4.3)和(27.4±3.2),P<0.01,在生后3周为(38.3±1.5)、(37.2±1.6)和(33.1±2.7),P<0.01。结论窒息越严重,血乳酸水平越高,NBNA评分越低,不良预后越多。
Objective To investigate the relationship between serum lactate levels and clinical prognosis in neonates with asphyxia. Methods The arterial blood lactic acid levels of 1,99 neonates with term asphyxia were measured by GEM Premier 3000 before and after birth, and their relationship with neonatal neurological behavioral score (NBNA score) and their adverse prognosis were observed. Results The levels of lactate in neonates at 1 h after birth were (3.56 ± 0.8) mmol / L, (8.32 ± 4.6) mmol / L and (12.13 ± 4.4) mmol / L respectively in the normal control group, mild asphyxia group and severe asphyxia group , P <0..01 and (1.52 ± 0.5) mmol / L, (3.4 ± 1.0) mmol / L and (6.3 ± 1.8) mmol / L respectively at 9h after birth The NBNA scores were (37.9 ± 2.1), (33.0 ± 4.3) and (27.4 ± 3.2), P <0.01, respectively, and were 38.3 ± 1.5, 37.2 ± 1.6 and 33.1 ± 2.7 weeks after birth respectively <0.01. Conclusion The more severe asphyxia, the higher the blood lactate level, the lower the NBNA score and the worse the prognosis.