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目的研究产时脐动脉血显示的不同类型酸血症与产时胎心监护图形变化的关系及产后４年随诊的结果。方法采用回顾性病例对照研究方法，选择对象为１９９１年单胎、足月分娩的２９８１例新生儿，产程中定时胎心监护，分娩时测定脐动脉血气。生后４年进行儿童随诊。结果纯代谢性酸血症４７例（代酸组），混合性酸血症６７例（混酸组），该两组在第一产程末，胎心率评分＜６和６～７分者发生率显著高于对照组。减速图形特点显示晚期减速与纯代谢性酸血症有关，而异常可变减速与混合性酸血症有关。两组产后１分钟Ａｐｇａｒ评分＜７分者也明显高于对照组。儿童４岁时随诊其发育、运动和语言能力显示：代酸组及混酸组和对照组比较差异无显著性，只在混酸组语言表达迟钝的例数略多。结论晚期减速可能是纯代谢性酸血症的一个表现，而异常可变减速可能是混合性酸血症的一个表现。两者均与１分钟Ａｐｇａｒ评分低分的发生有密切关系。产时酸血症和以后的语言发育缺陷间关系需进一步估价
Objective To study the relationship between different types of acidosis and labor-induced fetal heart rate changes during delivery and the results of follow-up of 4 years postpartum. Methods A retrospective case-control study was conducted. A total of 2981 newborns with singleton and full-term delivery in 1991 were enrolled in the study. The fetal heart rate was monitored during labor and the umbilical arterial blood gas was measured during labor. 4 years after childbirth. Results 47 cases of pure metabolic acidosis (substituting acid group), 67 cases of mixed acidosis (mixed acid group), the two groups in the end of the first stage of labor, fetal heart rate score <6 and 6 to 7 points incidence Significantly higher than the control group. Decelerating pattern characteristics show that late deceleration is associated with pure metabolic acidosis, whereas abnormally variable deceleration is associated with mixed acidosis. The Apgar scores <7 at 1 minute postpartum in both groups were also significantly higher than those in the control group. Children were followed up for development at 4 years of age. Motor and language proficiency showed that there was no significant difference between the acid-forming group and the mixed acid group and the control group, with only slightly more cases in the mixed acid group. Conclusions The late deceleration may be a manifestation of pure metabolic acidosis, while abnormally variable deceleration may be a manifestation of mixed acidosis. Both are closely related to the 1-minute Apgar score. The relationship between labor-induced acidosis and subsequent language developmental defects needs further evaluation