Apgar评分、脐动脉血pH值和乳酸联合应用于新生儿窒息诊断的价值

Value of Combined Detection of Apgar Score,Umbilical Artery Blood pH Value and Lactic Acid Level in Diagnosis of Neonatal Asphyxia

目的研究联合应用Apgar评分、脐动脉血pH值与乳酸诊断新生儿窒息的效果.方法选取2020年4月至2022年3月广州市番禺区妇幼保健院收治的100例新生儿窒息患儿为研究组,同期在本院分娩的200例正常新生儿为对照组,比较2组1 min Apgar评分、脐动脉血pH值及乳酸水平,并分析各单项指标及不同指标联合诊断新生儿窒息的准确率、灵敏度和特异度.结果研究组1 min Apgar评分、脐动脉血pH值和乳酸水平均高于对照组(均P<0.001).各单项指标中,1 min Apgar评分诊断准确率高于脐动脉血pH值和乳酸(均P<0.01)、灵敏度高于脐动脉血pH值(P<0.05)、特异度高于乳酸(P<0.01);联合指标中,1 min Apgar评分+脐动脉血pH值诊断准确率、灵敏度和特异度分别为80.67%、81.00%和80.50%,1 min Apgar评分+乳酸诊断准确率、灵敏度和特异度分别为80.00%、84.00%和78.00%,1 min Apgar评分+脐动脉血pH值+乳酸诊断准确率、灵敏度和特异度分别为95.00%、100.00%和92.50%,1 min Apgar评分+脐动脉血pH值+乳酸的诊断准确率、灵敏度和特异度高于1 min Apgar评分+脐动脉血pH值和1 min Apgar评分+乳酸(均P<0.001).结论在应用1 min Apgar评分与脐动脉血pH值的基础上联合乳酸检测能够提高新生儿窒息的诊断效果.

Objective To study the efficacy of combined detection of Apgar score,umbilical artery blood pH value and lactic acid level in the diagnosis of neonatal asphyxia.Methods One hundred infants with neonatal asphyxia admitted to Panyu District Maternal and Child Health Hospital of Guangzhou from April 2020 to March 2022 were taken as the study group,and 200 normal newborns delivered in Panyu District Maternal and Child Health Hospital of Guangzhou in the same period as the control group.One-min Apgar score,umbilical artery blood pH value and lactic acid level were compared between the two groups,and their accuracy,sensitivity and specificity for diagnosing neonatal asphyxia were analyzed.Results One-min Apgar score,umbilical artery blood pH value and lactic acid level in the study group were higher than those in the control group(P<0.001).The diagnostic accuracy of 1-min Apgar score was higher than that of umbilical artery blood pH value or lactic acid level(P<0.01).The sensitivity of 1-min Apgar score was higher than that of umbilical artery blood pH value(P<0.05),and the specificity of 1-min Apgar score was higher than that of lactic acid level(P<0.01).Furthermore,the accuracy,sensitivity and specificity of combined 1-min Apgar score,umbilical artery blood pH value and lactic acid level(95.00%,100.00%and 92.50%)were higher than those of combined 1-min Apgar score and umbilical artery blood pH value(80.67%,81.00%and 80.5%)or combined 1-min Apgar score and lactic acid level(80.00%,84.00%and 78.00%),respectively(P<0.001).Conclusion The combined detection of 1-min Apgar score,umbilical artery blood pH value and lactic acid level can improve the diagnostic efficacy in neonatal asphyxia.