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目的测定新生儿缺氧缺血性脑病(HIE)患儿脐血及外周动脉血pH值,探讨二者联合检测对新生儿缺氧缺血性脑损伤的临床诊断价值。方法选择2011年6月至2013年6月河北医科大学附属邢台市人民医院产科自然分娩的足月新生儿917例,于生后第1声啼哭前采集脐血,检测pH值;对其中生后1 min Apgar评分≤7分的138例新生儿于生后1 h抽取外周动脉血进行血气分析。比较单独检测脐血、外周动脉血及二者联合检测对HIE的检验效能。结果 pH<7.10作为预测新生儿HIE的指标时其阳性预测值为55.38%,灵敏度60.00%,特异度96.61%,脐带血联合生后1 h外周动脉血pH值预测HIE的阳性预测值95.74%、灵敏度88.26%,特异度97.10%。结论对于脐血pH<7.10的新生儿应当于生后1 h复查外周动脉血pH值,二者联合检测对新生儿HIE的预测具有较高的临床价值。
Objective To determine the value of umbilical cord blood and peripheral arterial blood pH in neonates with hypoxic-ischemic encephalopathy (HIE) and to explore the clinical value of their combined detection in neonatal hypoxic-ischemic brain damage. Methods From September 2011 to June 2013, 917 full-term newborns with obstetric delivery in Xingtai People’s Hospital affiliated to Hebei Medical University were enrolled. Umbilical cord blood was collected before the first cry of life and the pH was measured. One hundred and eighty newborns with Apgar score less than or equal to 7 were drawn 1 h after birth for peripheral blood sampling for blood gas analysis. Comparison of cord blood alone, peripheral arterial blood and the combination of the two test for the performance of HIE. Results The positive predictive value of HIE was 55.38%, the sensitivity was 60.00% and the specificity was 96.61%. The positive predictive value of peripheral arterial blood pH value of umbilical cord blood combined with 1 h after birth was 95.74% Sensitivity 88.26%, specificity 97.10%. Conclusion The newborns with umbilical blood pH <7.10 should be reviewed for the value of peripheral arterial blood 1 h after birth, and the combined detection of them has a high clinical value in the prediction of neonatal HIE.