摘要
目的探讨脐动脉血乳酸浓度与酸碱度(pH值)的相关性,评估脐动脉血乳酸浓度对新生儿酸中毒和窒息的预测及评估价值。方法选择2017年10月至2018年10月在山西大医院妇产科分娩孕周≥37周单胎活产新生儿1 355例,对新生儿脐动脉血乳酸浓度、pH值分布情况进行回顾分析及统计;使用Pearson相关性统计学方法分析脐动脉血乳酸浓度与pH值之间的相关性;使用ROC曲线以确定不同程度的酸中毒最具预测性的乳酸浓度截断值,设定不同程度的酸中毒模型为参考指标。结果新生儿脐动脉血乳酸值不符合正态分布,其中位数为4.95(3.5,6.6)mmol/L,脐动脉血乳酸浓度和pH值呈负相关,差异有统计学意义(P<0.05)。随着酸中毒程度的加重,脐动脉血乳酸浓度截断值逐渐增大,乳酸浓度诊断新生儿窒息的最佳预测值为12.35 mmol/L。结论新生儿脐动脉血乳酸浓度与pH值呈显著负相关,可作为分娩时新生儿酸中毒及窒息的有效参考指标。
Objective To investigate the correlation between umbilical arterial blood lactate concentration and pH, and to evaluate the predictive value of umbilical arterial blood lactate concentration in neonatal acidosis and asphyxia. Methods From October 2017 to October 2018, a total of 1 355 neonatal neonates born in the gestational age of ≥37 weeks in the Department of Obstetrics and Gynecology,Shanxi Grand Hospital were retrospectively analyzed. The lactic acid concentration and pH distribution of neonatal umbilical arteries were retrospectively analyzed. And using Pearson correlation statistical method to analyze the correlation between umbilical arterial blood lactate concentration and pH value;using ROC curve to determine the most predictive lactic acid concentration cutoff value of different degrees of acidosis, set different degrees of acidosis model as a reference indicator. Results The blood lactate value of neonatal umbilical arteries did not conform to the normal distribution. The median number was 4.95(3.5,6.6) mmol/L. The umbilical arterial blood lactate concentration and pH value were negatively correlated, the difference was statistically significant(P<0.05). With the aggravation of acidosis, the cutoff value of umbilical arterial blood lactate concentration gradually increased, and the optimal predictive value of lactic acid concentration for diagnosis of neonatal asphyxia was 12.35 mmol/L. Conclusion There is a significant negative correlation between umbilical arterial blood lactate concentration and pH value, which can be used as an effective reference index for neonatal acidosis and asphyxia during childbirth.
作者
曹春娟
吴素慧
CAO Chun-juan;WU Su-hui(Department of Gynecology and obstetrics,Shanxi Medical University,Taiyuan Shanxi 030001;Shanxi Grand Hospital,Taiyuan Shanxi 030032,P.R.China)
出处
《中国计划生育和妇产科》
2019年第11期68-72,共5页
Chinese Journal of Family Planning & Gynecotokology
关键词
脐动脉
乳酸
PH值
新生儿
酸中毒
umbilical artery
lactic acid
pH value
neonatal
acidosis
