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目的:分析轻、中、重度缺氧缺血性脑病(HIE)新生儿血电解质和阴离子间隙的改变及其相关性。方法:分析比较59例 不同程度的HIE新生儿和30例正常新生儿的血清钠、钾、氯、游离钙、测定AG值。结果:HIE新生儿中高AG30例,低AG8例,正 常AG21例。轻、中、重度HIE组高AG发生率分别为19.0％、81.9％、87.9％,代酸的发生率分别为4.2％、90.1％、100％,轻度 HIE组与中、重度HIE组比较均有非常显著性差异(P<0.01)。轻、中、重HIE儿的血清钠分别为(130.2±6.0)mmol/L,(125.9 ±9.0mmol/L.(120±12.8)mmol/L,游离钙分别为(1.0±O.2)mmol/L.(0.9±0.2)mmol/L,(0.8±O.2)mmol/L均低于正常新生 儿,而血清钾水平高于正常儿。轻度HIE患儿的血清氯水平与正常儿无差异,中和重度HIE儿的血清氯水平低于正常儿,中度与 重度HIE儿的血清钠、游离钙无显著差异,但均明显低于轻度HIE儿。轻、中、重HIE儿血清钾水平无明显差异。结论:HIE儿可 出现低钠、低钙、高钾;脑损伤的发生与高AG状态及其代酸的发生关系密切;这些病理状态与预后有关。
Objective: To analyze the changes of plasma electrolytes and anion gaps in neonates with mild, moderate and severe hypoxic-ischemic encephalopathy (HIE) and their correlation. Methods: The levels of serum sodium, potassium, chloride and free calcium in 59 HIE neonates and 30 normal neonates were analyzed and compared. The AG value was measured. Results: HIE in neonates with high AG30 cases, low AG8 cases, normal AG21 cases. The incidences of high AGEs in mild, moderate and severe HIE patients were 19.0%, 81.9% and 87.9% respectively, and the incidences of acidosis were 4.2%, 90.1% and 100% respectively in mild, moderate and severe HIE patients There is a very significant difference (P <0.01). The levels of serum sodium in mild, moderate and severe HIE infants were (130.2 ± 6.0) mmol / L, (125.9 ± 9.0 mmol / L. (120 ± 12.8) mmol / L, (0.9 ± 0.2) mmol / L, (0.8 ± 0.2) mmol / L were lower than normal newborns, while serum potassium levels were higher than those in normal children. Serum chlorine levels in children with mild HIE were significantly higher than those in normal children No difference, moderate and severe HIE children serum chloride levels were lower than normal children, moderate and severe HIE children serum sodium, free calcium was no significant difference, but were significantly lower than mild HIE children. There was no significant difference in serum potassium levels.Conclusion: HIE may have hyponatremia, hypocalcemia and hyperkalemia. The occurrence of brain injury is closely related to the development of high AG and its acid formation. These pathological states are related to the prognosis.