Dynamic Monitoring Arterial Serum Lactate And Biochemical Indicators Of MSAF Neonates And Its Clinical Significance In The Early Application Of Perinatal Asphyxia

PartⅠDynamic monitoring arterial serum lactate and blood gas analysisof MSAF neonates and its clinical significance in the early application ofperinatal asphyxiaObjective To investigate the influences of MSAF neonates on the umbilical artery andarterial serum lactate and blood gas analysis and its clinical application value of earlydiagnosis of perinatal asphyxia. Methods A total of190term neonatal meconium stainedamniotic fluid (MSAF) patients were selected and divided into three groups according tothe degree of MSAF.Among of them,a total of53term neonatal axphyxic patients weredivided into two groups according to the degree of axphyxia. The patients in controlgroup(n=71) were selected of high risk infants born during the same period into theneonatal intensive care unit.Based on this, the umbilical artery and arterial serum lactatelevel and blood gas analysis were compared between the three groups during deferentperiods after birth.Results The levels of umbilical artery lactate in severe MASF group were significantlyhigher than those in control groups(P <0.05),and which in severe group were significantlyhigher than those in control group and mild group(P <0.05). The levels of umbilical arterylactate in severe asphyxic group were significantly higher than those in control groups(P<0.05),and which in severe group were significantly higher than those in mild group(P<0.05).The levels of umbilical arterial lactate were significantly correlated with pH,BE,HCO3-and TCO2in control and severe MASF groups.The levels of umbilical arteriallactate in severe asphyxia group was significantly higher than in control and mild group. The levels of arterial lactate were significantly higher than umbilical arterial lactate,andreached the peak in the first3hour of life in mild asphyxia group,and reached the peak inthe first6hour of life in severe asphyxia group.The sensitivity and specificity of arterialserum lactate were significantly higher than umbilical arterial lactate in the diagnosis ofperinatal asphyxia.Conclusion Dynamic monitoring the level of umbilical arterial and arterial lactate andblood gas analysis after have the important significance for the early diagnosis of perinatalasphyxia and its degree.The umbilical arterial lactate can directly reflect the hypoxia andacid-base status,thus it has higher value than pH. The sensitivity and specificity of arterialserum lactate in the first3hour of life were significantly higher than umbilical arteriallactate in the early diagnosis of perinatal asphyxia.Part Ⅱ Dynamic monitoring arterial serum inflammatory factors ofneonates and its clinical significance in early application of perinatalasphyxiaObjective To investigate the influences of perinatal asphyxia on the umbilical artery andarterial serum inflammatory and its clinical application value.Methods A total of53term MSAF asphyxia neonates were selected and divided into twogroups according to the degree of asphyxia. The patients in control group(n=71) wereselected of high risk infants born during the same period in the neonatal intensive careunit.Based on this, the serum level of TNF-α、HMGB1、NSE were compared between thethree groups.Results The levels of TNF-α、HMGB1and NSE in asphyxia group were significantlyhigher than those in control group(P <0.05),and which in severe group were significantlyhigher than those in control group and mild group(P <0.05). The levels of TNF-α in controlgroup and mild group reached the peak in the first day of life,and then decreased gradually.The level of TNF-α in severe group reached the peak after birth,and then decreased gradually. The level of HMGB1in control group reached the peak in the first day oflife,and then decreased gradually. The level of HMGB1in asphyxia group reached the peakin the second day of life,and then decreased gradually. The serum level of NSE in arterywas increased significantly than umbilical artery, and reached the peak immediately afterbirth in the control group, and asphyxia group reached the peak in the first day, thengradually declined. NSE in abnormal head ultrasound and amplitude integatedelectroencephalogram group were significantly higher than those in control group(P<0.05).Conclusion Dynamic monitoring the levels of TNF-α、HMGB1and NSE after perinatalasphyxia have the important significance for the early diagnosis of organ injury、its degreeand recent prognosis.