摘要
Abstract
Objective To study the predictive value of umbilical artery blood gas analysis combined with early postnatal myocardial enzyme spectrum for neonatal respiratory distress syndrome(RDS)and its severity in premature infants.Methods From January 2018 to December 2024,85 newborns with the gestation age of 30-36+6 weeks who were diagnosed as RDS after birth form Hangzhou Women's Hospital were selected as study group.85 newborns without diagnosed as RDS during the same period were included as control group in a 1:1 ratio.All of them born by cesarean section.The umbilical arterial blood gas analysis was performed and blood samples were collected for blood biochemical tests.The umbilical artery blood pH,base excess,lactate,and myocardial enzyme spectrum such as aspartate aminotransferase(AST),lactate dehydrogenase(LDH),creatine kinase isoenzymes(CK-MB)were compared between two groups.Binary Logistic regression was used to analyze the correlation between umbilical artery blood gas analysis and venous blood myocardial enzyme spectrum and RDS.Receiver operating characteristic curve of umbilical artery blood pH value and creatine kinase isoenzyme alone and their combined detection for predicting RDS was detected,and area under the curve(AUC),sensitivity and specificity of the single detection and combined detection were compared.The study group was further divided into subgroup A(mild)and subgroup B(severe)and the differences of the above indicators between two subgroups were compared.Results Compared with control group,tstudy group had lower pH and base excess levels in umbilical artery blood as well as AST,LDH and CK-MB were higher than those in control group with statistically significant differences(P＜0.05).pH and CK-MB were correlated with RDS(P＜0.05).The AUC of umbilical artery blood pH in predicting RDS was 0.728,the sensitivity was 0.588 and the specificity was 0.812.Combined with CK-MB,the AUC of predicting RDS was 0.813,the sensitivity was 0.729,and the specificity was 0.824.In the study group,subgroup A had higher pH and base excess levels in umbilical artery blood as well as AST,LDH and CK-MB were lower than those in subgroup B with statistically significant differences(P＜0.05).CK-MB was correlated with disease severity in newborns with RDS(P＜0.01).Conclusion Compared with simple application of pH,the combined use of CK-MB can more accurately predict RDS in premature infants,and also has a certain significance for the severity of RDS in premature infants.关键词
脐动脉血气分析/心肌酶谱/呼吸窘迫综合征/早产儿/pH/肌酸激酶同工酶Key words
Umbilical arterial blood gas analysis/Myocardial enzyme spectrum/Respiratory distress syndrome/Premature infants/pH/Creatine kinase isoenzymes分类
医药卫生
