Brucknerová Ingrid, Benedeková Marta, Holomán Karol, Bieliková Eva, Kostrová Alena, Ujházy Eduard, Dubovický Michal
1st Department of Pediatrics, Medical School, Comenius University, Bratislava, Slovak Republic.
Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2005 Dec;149(2):409-11.
A new aspect on delivery as "physiological stress" provides the possibility for assessing its influence in asphyxial newborns. Asphyxia is characterized by hypoxic ischemic damage of organs with subsequent damage due to reoxygenation and reperfusion. The aim of the study was to compare the activity of liver enzymatic systems of healthy newborns with asphyxial newborns. Reference values of the AST on the 1st day of life 0.80 +/- 0.12 microkat/l and on the 5th day of life 0.78 +/- 0.11 microkat/l, of the ALT on the 1st day of life 0.29 +/- 0.04 microkat/l and on the 5th day of life 0.54 +/- 0.21 microkat/l and of the quotient of DeRitis on the 1(st) day of life 3.35 +/- 0.6 and on the 5th day of life 2.14 +/- 0.22 were established. The quotient of DeRitis expresses better the influence of stress on healthy term newborns since isolated evaluation of liver enzymes and their dynamics, which is decreased on the 5th day of life shows stabilization of the baby and improvement of liver cell function in comparison with the 1st day of life. The authors found that delivery is considered to be a certain form of physiological stress.
将分娩视为“生理应激”这一新观点为评估其对窒息新生儿的影响提供了可能。窒息的特征是器官的缺氧缺血性损伤，随后因再氧合和再灌注而造成进一步损伤。本研究的目的是比较健康新生儿与窒息新生儿肝脏酶系统的活性。确立了出生第1天谷草转氨酶（AST）的参考值为0.80±0.12微卡特/升，出生第5天为0.78±0.11微卡特/升；出生第1天谷丙转氨酶（ALT）的参考值为0.29±0.04微卡特/升，出生第5天为0.54±0.21微卡特/升；出生第1天德瑞蒂斯比值（DeRitis quotient）为3.35±0.6，出生第5天为2.14±0.22。德瑞蒂斯比值能更好地体现应激对健康足月儿的影响，因为单独评估肝脏酶及其动态变化时，出生第5天该比值下降，表明与出生第1天相比，婴儿情况稳定且肝细胞功能有所改善。作者发现，分娩被认为是一种特定形式的生理应激。
