Lactic Acid And Prealbumin Determination For Evaluation Of Neonatal Asphyxia And Combined Liver Injury

Objectives:To detect the changes of blood lactic acid and prealbumin in different degrees of asphyxia in term neonates,investigating the changes of blood lactate and prealbumin in different degrees of asphyxia in term newborns and the diagnostic value of liver injury after neonatal asphyxia.Methods:73 full-term asphyxia neonates admitted to the Second Affiliated Hospital of Kunming Medical University from January 2017 to December 2018 were enrolled in the asphyxia group(44 in the mild asphyxia group and 29 in the severe asphyxia group).71 neonates who did not have asphyxia at the same time served as a control group.In the asphyxia group and the control group,1 ml of arterial blood was taken during admission examination within 3 hours after admission recovery period,and arterial blood lactate(Lac),PH value and alkali residual(BE)were detected by dry electrochemical method/AC impedance method.The control group received 3 ml of venous blood within 48 hours after admission and in the asphyxia group within 48 hours after admission and during the recovery period.and pre-albumin(PAB),albumin(ALB),alanine aminotransferase(ALT),and aspartate aminotransferase(AST)were detected by an automatic biochemical analyzer.The levels of Lac,PH,BE,and PAB,ALB,ALT,and AST in the mild asphyxia group,severe asphyxia group,and control group were compared.Collect and organize data using Excel.Statistical analysis was performed using the SPSS 22.0 statistical software package.Results:1.Comparison of general information between the asphyxiation group and the control group:There were no significant differences in gender,gestational age and birth weight(P>0.05).One-minute and five-minute APGAR scores were statistically significant at admission.(P<0.01).2.PH level:The asphyxia group(7.067±0.15)and control group(7.20±0.10);The mild asphyxia group(7.10±0.11)compared to the severe asphyxia group(6.99=1=0.18)were statistically different(P<0.05),and the of level PH severe asphyxia group<mild asphyxia group<control group.3.Lactic acid level:asphyxia group 4.45(3.09,6.98)mmol/L and control group 3.1(2.35,4.2)mmol/L;The mild asphyxia group3.96(3.04,5.04)mmol/L compared to the severe asphyxia group 6.3(3.61,11.14)mmol/L were statistically different(P<0.05),and the of level Lactic acid severe asphyxia group>mild asphyxia group>control group.4.BE negative level:asphyxia group(-15.78±5.74)mmol/L and control group(-8.4316.26)mmol/L;The mild asphyxia group(-14.40±4.34)mmol/L compared to the severe asphyxia group(-17.92±6.97)mmol/L were statistically different(P<0.05),and the of level BE negative level severe asphyxia group<mild asphyxia group<control group.5.Prealbumin level:asphyxia group(77.89±18.65)mg/L and control group(104.91 ±21.42)mg/L;The mild asphyxia group(81.55±19.57)mg/L compared to the severe asphyxia group(72.20±15.81)mg/L were statistically different(P<0.05),and the of level Lactic acid severe asphyxia group<mild asphyxia group<control group.6.Albumin level:asphyxia group(35.38±9.67)g/L and control group(36.31 ±3.50)g/L;The mild asphyxia group(36.70±2.06)g/L compared to the severe asphyxia group(33.32±2.86)g/L were no statistically different(P>0.05).7.ALT level:asphyxia group(46.50±25.56)u/L and control group(22.63±10.51)u/L;The mild asphyxia group(39.18±20.7)u/L compared to the severe asphyxia group(57.86±28.48)u/L were statistically different(P<0.05),and the of level Lactic acid severe asphyxia group>mild asphyxia group>control group.8.AST level:asphyxia group64.00(45.5,105.25)u/L and control group 40.0(33.0,57.00)u/L;The mild asphyxia group60.50(44.50,81.0)u/L compared to the severe asphyxia group83.00(50.56,128.00)u/L were statistically different(P<0.05),and the of level Lactic acid severe asphyxia group>mild asphyxia group>control group.9.The average level of AST/ALT ratio in the severe asphyxia group was slightly larger than that in the mild asphyxia group,but the two groups were not statistically significant(P>0.05).10.Comparison of abnormal rates of PAB and ALT in different degrees of asphyxia groups:The abnormal rate of PAB in mild and severe asphyxia group was greater than that in ALT.There was significant difference in PAB and ALT levels after full-term asphyxia(P<0.01).11.Changes in ALT,AST,and PAB in asphyxia group:In the asphyxia group,the levels of ALT and AST were lower than those before treatment,and the level of PAB was higher than that before treatment.The difference was statistically significant(P<0.05).There was no significant change in albumin before and after treatment,and there no statistical significance(P>0.05).12.Analysis by ROC curve:The area under the curve of PAB was 0.851,the standard error was 0.033,P<0.001.When the serum PAB was 83.5 mg/l,the Yoden index was up to 0.851,the sensitivity was 0.944,and the specificity was 0.92.The area under the ALT curve was 0.831,the standard error was 0.045,P<0.001.When the serum ALT>80u/l,the Yoden index was 0.25,the sensitivity was 0.276,and the specificity was 0.974.13.A scatter plot fitted by linear regression:The data points of ALT and Lac are scattered,and there may be no relationship between the two variables.The data points of PAB and Lac are basically a straight line,and there is a negative linear relationship between the two variables.Conclusions:1.As the degree of neonatal asphyxia increases,Lac levels increase,and PAB levels decrease,ALT and AST levels increase;the higher the Lac value,the lower the PAB level,the heavier the liver injury in neonates with asphyxia.2.Neonatal ALT abnormal rate in severe asphyxia is higher than mild asphyxia neonates.But the level of ALT changes is not high in the clinical diagnosis of mild asphyxia neonates with liver injury.3.PAB abnormal rate is high in mild asphyxia,and PAB is more valuable than ALT in the diagnosis of liver injury after asphyxia.