新生儿窒息后高胆红素血症阴离子间隙分析

Analysis on anion gap of the neonates with hyperbilirubinemia after asphyxia

目的:探讨窒息后高胆红素血症新生儿的阴离子间隙(anion gap,AG)变化,为治疗提供依据。方法:测定62例窒息后高胆红素血症新生儿的血电解质、肾功能、肝功能,计算AG值,46例同时做动脉血气分析。结果:高AG 28例(45.16%)、正常AG 32例(51.61%)、低AG 2例(3.23%)。AG增高与血Na+浓度成正比,与HCO3-呈反比,与血Cl-和BUN、Scr无明显相关性。轻、重度窒息后高胆红素血症新生儿的AG水平、高AG发生率、血电解质及肾功能比较均无显著性差异。结论:窒息后高胆红素血症新生儿高AG代酸发生率高,应常规测定血电解质及动脉血气分析,计算AG值指导治疗,以免盲目用碱纠酸。

Objective：To explore the change of aninon gap（AG） among the neonates with hyperbilirubinemia after asphyxia,provide a basis for treatment. Methods：The blood electrolytes,renal function,and liver function of 62 neonates with hyperbilirubinemia after asphyxia were detected,then AG levels were calculated,34 neonates received arterial blood gas analysis simultaneously. Results：28 neonates were found with high AG level,accounting for 45.16%;32 neonates were found with normal AG level,accounting for 51.61%;2 neonates were found with low AG level,accounting for 3.23%.The increase of AG level was positively correlated with blood Na＋ content,and it was negatively correlated with HCO3-,there was no correlation between AG level and blood Cl-,BUN,and Scr.There was no significant difference in AG level,incidence of high AG,blood electrolytes,and renal function between the neonates with hyperbilirubinemia after mild and severe asphyxia. Conclusion：The incidence of metabolic acidosis with high AG among the neonates with hyperbilirubinemia after asphyxia was high,blood electrolytes and arterial blood gas analysis should be detected regularly,and AG level should be calculated to direct treatment and avoid correcting acidosis with alkali blindly.