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目的探讨尿乳酸/肌酐比值与新生儿窒息发生的相关性,分析尿乳酸/肌酐比值在预测新生儿缺氧缺血性脑病(HIE)中的应用价值。方法选取2013年10月~2014年10月该院儿科发生窒息的新生儿60例为研究组,另选取同期健康新生儿60例为健康组。检测出生后1天新生儿尿乳酸/肌酐比值、尿N-乙酰-β-D-氨基葡萄糖苷酶(NAG)/肌酐比值和Apgar评分,并分析两组新生儿尿乳酸/肌酐比值、尿NAG/肌酐比值与新生儿HIE发生的关系。结果研究组新生儿1 min和5 min Apgar评分均显著低于健康组(P<0.05),出生后1天尿乳酸/肌酐比值及尿NAG/肌酐比值均显著高于健康组(P<0.05);研究组新生儿生后1d尿乳酸/肌酐比值与1 min和5 min Apgar评分均呈负相关(r=-0.574、-0.862,P均<0.05),出生后1天尿乳酸/肌酐比值与尿NAG/肌酐比值呈正相关(r=0.417,P<0.05)。结论尿乳酸/肌酐比值对新生儿窒息的预后评估具有重要作用,同时可作为早期预测新生儿HIE的重要指标,对新生儿HIE的早期诊断和监护具有重要价值。
Objective To investigate the correlation between urinary lactate / creatinine ratio and neonatal asphyxia, and to evaluate the value of urinary lactate / creatinine ratio in predicting neonatal hypoxic-ischemic encephalopathy (HIE). Methods From October 2013 to October 2014, 60 neonates with asphyxia in pediatric department of our hospital were selected as the study group, and 60 healthy newborn children in the same period were selected as the healthy group. The urinary lactate / creatinine ratio, urinary N-acetyl-β-D-glucosaminidase (NAG) / creatinine ratio and Apgar score were measured at 1 day after birth. Urinary lactate / creatinine ratio / Creatinine ratio and the occurrence of neonatal HIE. Results The Neonatal 1 and 5 min Apgar scores in the study group were significantly lower than those in the healthy group (P <0.05). The ratio of urinary lactate to creatinine and urine NAG / creatinine were significantly higher in the newborn group than those in the healthy group (P <0.05) ; The urinary lactate / creatinine ratio at 1 day after birth in neonates was negatively correlated with Apgar scores at 1 minute and 5 minutes (r = -0.574, -0.862, P <0.05). The ratio of urinary lactate to creatinine at 1 day after birth Urinary NAG / creatinine ratio was positively correlated (r = 0.417, P <0.05). Conclusions The ratio of urinary lactate to creatinine plays an important role in the assessment of prognosis of neonatal asphyxia, and can be used as an important index for early prediction of neonatal HIE. It is of great value in the early diagnosis and monitoring of neonatal HIE.