Temporal Change Of Blood Lactate And Glucose In Term Asphyxia Neonate

Objective:To explore the clinical significance of the temporal change of blood lactate in relation to the temporal change of blood glucose,in asphyxial neonates.Methods:According to Apgar score,159 term newborn infants were divided into mild and severe asphyxia groups.Other 20 normal term babies were included in healthy control group.Arterial blood of each baby was colleted at 1 h,6 h and 24 h after birth.I-STAT micro-quantity blood gas analyzer and Instant blood glucose analyzer were then used to measure blood lactic acid level and blood glucose level in each blood sample.The statistical analysis of the data obtained was performed using one-factor analysis.Results:(1)At 1h,6h and 24h time point,the blood glucose level:In normal control group,it was(4.99±1.14),(4.35±1.98)and(5.12±1.55)mmol/L, respectively.In mild asphyxia group,it was(4.39±1.95),(4.60±1.26)and (4.73±1.53),respectively.In severe asphyxia group,it was(4.51±2.00), (4.96±1.89)and(4.72±1.38)mmol/L,respectively.In normal Apgar Score asphyxia group was(3.40±1.40),(4.40±1.22)and(4.57±1.38)mmol/L, respectively.There was significant difference between the previous three groups to normal Apgar score asphyxia group(P＜0.05).(2)At 1h,6h and 24h time point,the blood lactate level:In normal control group,it was(3.51±2.43),(3.07±2.29)and(4.19±2.88)mmol/L, respectively.In mild asphyxia group,it was(5.38±2.81),(3.80±2.20)and (4.49±2.45)mmol/L,respectively.In severe asphyxia group,it was (9.17±4.93),(5.21±3.06)and(5.55±3.04)mmol/L,respectively.In normal Apgar Score asphyxia group was(3.27±1.82),(3.79±2.26)and (4.18±2.53)mmol/L,respectively.At 1h after birth,there was significant difference between severe group and the other groups(P＜0.05).(3)At 1h after birth,the blood lactate was negatively correlated to Apgar score(R~2 = 0.454,p＜0.01)and positively correlated to blood glucose level(R~2 = 0.035,p＜0.05).Conclusions:Blood glucose does not have indicating significance for assessing asphyxia severity in term neonates.While in a short period after birth, there was a possible positive correlationship between blood lactate and glucose levels.Blood lactate level may possess indicating significance for assessing asphyxia severity.Blood lactate can be used as a useful parameter for the diagnosis and treatment of neonatal asphyxia.