新生儿窒息血气分析指标变化与血清神经系统相关性蛋白的分析研究

Analysis and study on changes of blood gas analysis indexes and serum nervous system associated proteins in neonata asphyxia

目的观察窒息新生儿的血气分析指标与血清神经系统相关性蛋白水平的变化,分析各指标与窒息的相关性。方法收集我院2016年4月～2018年3月足月的窒息后复苏新生儿60例作为病例组,根据Apgar评分分为轻度窒息(n=36)和重度窒息(n=24)两个亚组,同期足月健康新生儿60例作为对照组,均于生后2h内抽取桡动脉血进行血气分析,并采用电化学发光法检测血清神经元特异性烯醇化酶(NSE)和S100蛋白,建立直线回归方程,采用Spearman相关性检验血气分析指标、NSE和S100蛋白与新生儿窒息的相关性。结果轻度窒息、重度窒息组、对照组三组间氧合指数、PH值、NSE、S100蛋白差异均有统计学意义(P <0.05)。重度组PO_2、PCO_2与对照组、轻度窒息组差异均有统计学意义(P <0.05)。而轻度窒息、对照组PO_2、PCO_2差异无统计学意义(P> 0.05)。PO_2与NSE、S100蛋白呈弱正相关,PCO_2与NSE、S100蛋白呈弱负相关,氧合指数、PH值与NSE、S100蛋白呈中度负相关,NSE与NSE、S100蛋白呈中度正相关,S100蛋白呈高度正相关。结论动脉血气分析中PH值和氧合指数变化可较敏感的反映窒息新生儿脑损伤程度。

Objective To observe the changes of blood gas analysis index and serum nervous system related protein level in asphyxiated newborns,and to analyze the correlation between each index and asphyxia. Methods Sixty cases of neonates resuscitated after asphyxia in our hospital from April 2016 to March 2018 were collected as case group.According to Apgar score,the patients were divided into two subgroups:mild asphyxia(n=36) and severe asphyxia(n=24).In the same period,60 healthy full-term newborns served as control group.The blood gas of radial artery was analyzed within 2 hours after birth.Serum neuron specific enolase(NSE) and S100 protein were detected by electrochemical luminescence method.The linear regression equation was established.Spearman correlation test was used to examine the correlation between blood gas analysis index,NSE and S100 protein and neonatal asphyxia.Results There were significant differences in oxygenation index,PHvalue,NSE and S100 protein between mild asphyxia group,severe asphyxia group and control group(P < 0.05).There were significant differences in PO2 and CO2 between severe group and control group and mild asphyxia group(P < 0.05).However,there was no significant difference between mild asphyxia and control group(P > 0.05).PO2 was weakly positively correlated with NSE and S100 proteins,while PCO2 was weakly negatively correlated with NSE and S100 proteins.Oxygenation index and PH value were moderately negatively correlated with NSE and S100 proteins.NSE was moderately positively correlated with NSE and S100 proteins,and highly positively correlated with S100 proteins. Conclusion The changes of PH value and oxygenation index in arterial blood gas analysis can reflect the degree of brain injury in asphyxiated newborns more sensitively.