血气、电解质分析及CK、CK-MB、HBDH在新生儿窒息中的变化与临床意义

Clinical significance of blood gas and electrolyte analysis,CK,CK-MB and HBDH changes in neonatal asphyxia

目的:探讨血气、电解质分析及CK、CK-MB、HBDH在新生儿窒息中的变化及临床意义。方法:将2013年1月~2015年12月镇江市第一人民医院收治的100例新生窒息患儿,按照窒息程度阿普加评分(Apgar)分为重度组和轻度组,重度组20例,轻度组80例,另取50例健康新生儿作为对照组。采用血气分析仪对各组进行动脉血气分析,观察动脉血酸碱度(pH值)、剩余碱(BE)、二氧化碳分压(PaCO_2),同时检测电解质(K^+、Na^+、Ca^(2+))及肌酸激酶(CK)、肌酸激酶同工酶(CK-MB)、α-羟丁酸脱氢酶(HBDH)三种酶水平并进行比较。结果:与对照组相比,重度组患儿血气指标pH值、BE明显降低(P<0.05),PaCO_2明显升高(P<0.05),轻度组pH值、BE、PaCO_2无明显差异(P>0.05),与轻度组相比,重度组血气指标pH值、BE下降更显著(P<0.05),PaCO_2升高更显著(P<0.05);与对照组相比,重度组与轻度组患儿Ca^(2+)明显降低(P<0.05),K^+、Na^+无明显差异(P>0.05),与轻度组相比,重度组Ca^(2+)下降更显著(P<0.05);与对照组相比,重度、轻度两组患儿CK、CK-MB、HBDH均显著升高(P<0.05),与轻度组相比,重度组CK-MB上升更显著(P<0.05)。结论:对新生儿动脉血进行血气、电解质分析及CK、CK-MB、HBDH测定,可为新生儿窒息的诊断及严重程度的判断提供客观依据,有助于了解病情变化,指导临床治疗。

Objective：To investigate the clinical significance of blood gas and electrolyte analysis,CK,CK-MB and HB-DH changes in neonatal asphyxia.Methods：A total of 100 newborns with asphyxia who visited in our hospital were collected, and divided into severe group （n =20）and mild group （n =80）according to the asphyxia degree,and 50 healthy newborns re-garded as control group.The 3 groups received blood gas analysis （pH,BE and PaCO 2 ）,electrolyte （K＋ ,Na＋ and Ca2 ＋ ）and 3 kinds of enzymes （CK,CK-MB and HBDH）were tested and compared.Results：Compared with control group,pH and BE of blood gas indexes decreased significantly and PaCO 2 increased significantly in severe group （P 〈0.05）.There was no signifi-cant difference on blood gas indexes （pH,BE and PaCO 2 ）in mild group （P 〉0.05）.Compared with mild group,pH and BE of blood gas indexes decreased significantly and PaCO 2 increased significantly in severe group （P 〈0.05）;Compared with con-trol group,the level of Ca2 ＋ decreased significantly in severe and mild group （P 〈0.05）,and the levels of K＋ and Na＋ had nonbsp;significant difference in severe and mild group （P 〉0.05）.Compared with mild group,the level of Ca2 ＋ decreased significantly in severe group （P 〈0.05）;Compared with control group,the levels of CK,CK-MB and HBDH increased significantly in se-vere and mild group （P 〈0.05）.Compared with mild group,the levels of CK,CK-MB and HBDH increased significantly in se-vere group （P 〈0.05）.ConclusionS：The detection of blood gas and electrolyte analysis,CK,CK-MB and HBDH can provide an objective evidence for the diagnosis of neonatal asphyxia and estimation of severity degree which was helpful in clinical treat-ment.