Groenendaal Floris, Lindemans Caroline, Uiterwaal Cuno S P M, de Vries Linda S
Department of Neonatology, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, The Netherlands.
Biol Neonate. 2003;83(3):171-6. doi: 10.1159/000068927.
In the present study early arterial lactate samples were examined to predict adverse outcome in preterm neonates.
88 preterm neonates (mean gestational age 29.8 weeks, mean birth weight 1,225 g) had arterial lactate levels measured from indwelling arterial catheters within the first 3 h of life. An adverse outcome was defined as death or abnormal neurodevelopment. The positive (PPV) and negative predictive value (NPV) of early arterial lactate levels for an adverse outcome (death or neurodevelopmental abnormalities) were calculated using receiver operating characteristic analysis.
PPV and NPV of arterial lactate within 3 h after birth were 0.47 and 0.92, respectively, with a cutoff value of 5.7 mmol/l. Umbilical blood gas values and 1 and 5 min Apgar scores had much lower PPVs.
Arterial lactate levels within 3 h of life can be used to select preterm neonates who are at risk of an adverse outcome.
在本研究中，对早产新生儿早期动脉血乳酸样本进行检测，以预测不良结局。
88例早产新生儿（平均胎龄29.8周，平均出生体重1225克）在出生后3小时内通过留置动脉导管测量动脉血乳酸水平。不良结局定义为死亡或神经发育异常。使用受试者工作特征分析计算早期动脉血乳酸水平对不良结局（死亡或神经发育异常）的阳性预测值（PPV）和阴性预测值（NPV）。
出生后3小时内动脉血乳酸的PPV和NPV分别为0.47和0.92，临界值为5.7毫摩尔/升。脐血气值以及1分钟和5分钟阿氏评分的PPV要低得多。
出生后3小时内的动脉血乳酸水平可用于筛选有不良结局风险的早产新生儿。
