Mateos Antón F, García Puig J, Ramos Hernández T, Carranza Ramos R, López Jiménez M, Ortiz Vázquez J
Servicio de Bioquímica Clínica, Hospital La Paz, Madrid.
An Esp Pediatr. 1989 Jul;31(1):5-9.
We determined blood pH, plasma hypoxanthine (Hx) and intraerythrocyte ATP (iATP) concentrations in umbilical cord blood from 20 normal newborn infants (10 delivered by the vaginal route and 10 by caesarean section) and in 18 newborns with clinical signs of perinatal asphyxia (9 with meconium stained amniotic fluid and 9 with fetal bradycardia). Blood pH was significantly lower in infants with clinical signs of perinatal asphyxia (p less than 0.01). Four newborns with meconium or bradycardia had pH values within normal control levels. Hx concentrations were lower in infants delivered by caesarean section with respect to normal infants born by the vaginal route (p less than 0.05). Newborns with meconium or fetal bradycardia showed Hx concentrations higher than normal newborns (p less than 0.01), but 2 infants with signs of perinatal hypoxia had Hx levels within the normal newborn range. All babies with meconium or bradycardia had an iATP concentration lower than control infants (p less than 0.01). These results indicate that: the pH and Hx determinations in the newborn may underestimate hypoxia and, that measurement of iATP may be useful parameters to asses perinatal hypoxia.
我们测定了20例正常新生儿（10例经阴道分娩，10例剖宫产）脐带血中的血液pH值、血浆次黄嘌呤（Hx）和红细胞内ATP（iATP）浓度，以及18例有围产期窒息临床体征的新生儿（9例羊水粪染，9例胎儿心动过缓）的上述指标。有围产期窒息临床体征的婴儿血液pH值显著降低（p<0.01）。4例有胎粪或心动过缓的新生儿pH值在正常对照水平范围内。剖宫产分娩的婴儿Hx浓度低于经阴道分娩的正常婴儿（p<0.05）。有胎粪或胎儿心动过缓的新生儿Hx浓度高于正常新生儿（p<0.01），但2例有围产期缺氧体征的婴儿Hx水平在正常新生儿范围内。所有有胎粪或心动过缓的婴儿iATP浓度均低于对照婴儿（p<0.01）。这些结果表明：新生儿的pH值和Hx测定可能低估缺氧情况，而iATP测定可能是评估围产期缺氧的有用参数。
