Apgar评分及脐带血pH值对足月新生儿窒息的预测价值及其与严重程度的相关性

Predictive Value of Apgar Score and pH Value of Cord Blood in Neonatal Asphyxia in Full-term Neonates and Their Correlation with Severity of Disease

目的评估Apgar评分及脐带血pH值对足月新生儿窒息的预测价值,探讨Apgar评分及脐带血pH值与足月新生儿窒息严重程度的相关性。方法选取窒息足月新生儿46例作为窒息组,健康足月新生儿49例作为健康组,比较两组出生1、5 min Apgar评分和脐带血pH值;采用受试者工作特征(receiver operating characteristic curve,ROC)曲线分析出生1、5 min Apgar评分,脐带血pH值和三者联合检测对足月新生儿窒息的预测价值;采用Spearman等级相关性分析探讨1、5 min Apgar评分和脐带血pH值与足月新生儿窒息严重程度的相关性。结果窒息组出生1、5 min Apgar评分和脐带血pH值显著低于健康组,差异有统计学意义(P<0.01);ROC曲线分析结果显示,出生1、5 min Apgar评分+脐带血pH值联合检测对足月新生儿窒息的预测价值最高。轻度窒息亚组出生1、5 min Apgar评分和脐带血pH值均显著高于重度窒息亚组,差异有统计学意义(P<0.05或P<0.01);Spearman等级相关性分析结果显示,出生1、5 min Apgar评分和脐带血pH值与足月新生儿窒息严重程度均呈负相关(P<0.05或P<0.01)。结论出生1、5 min Apgar评分+脐带血pH值联合检测对足月新生儿窒息具有较好的预测价值,且Apgar评分及脐带血pH值与足月新生儿窒息严重程度具有相关性。

Objective To evaluate the predictive value of Apgar score and cord blood pH value in the diagnosis of neonatal asphyxia in full-term neonates,and to explore their relationship with the severity of neonatal asphyxia in full-term neonates.Methods Forty-six full-term newborns were selected as the asphyxia group and 49 healthy full-term newborns as the healthy group.The differences of Apgar scores at 1 min and 5 min after birth and pH value of cord blood were compared.The predictive value of Apgar scores at 1 min and 5 min after birth,pH value of cord blood and the combination of the three in the diagnosis of neonatal asphyxia was evaluated by receiver operating characteristic(ROC)curve,respectively.Spearman rank correlation analysis was performed to explore the correlation of Apgar scores at 1 min and 5 min after birth and pH value of cord blood with severity of neonatal asphyxia.Results Apgar scores at 1 min and 5 min after birth and the pH value of cord blood in asphyxia group were significantly lower than those in the healthy group(P<0.01).The ROC curve analysis results showed that the combined detection of 1 min and 5 min Apgar scores and cord blood pH had the highest predictive value for neonatal asphyxia in full-term neonates.Apgar scores at 1 min and 5 min after birth and cord blood pH value of neonates were significantly higher in mild asphyxia subgroup than in severe asphyxia subgroup(P<0.05 or P<0.01).Spearman rank correlation analysis results showed that Apgar scores at 1 min and 5 min after birth and cord blood pH were negatively correlated with the severity of neonatal asphyxia in full-term neonates(P<0.05 or P<0.01).Conclusion Apgar scores at 1 min and 5 min after birth and cord blood pH value have a better predictive value for the occurrence of neonatal asphyxia in full-term neonates.Apgar score and cord blood pH value are correlated with the severity of neonatal asphyxia in full-term neonates.