Swanström S, Bratteby L E
Pediatr Res. 1982 Feb;16(2):156-60. doi: 10.1203/00006450-198202000-00016.
The possibility of detecting past hypoxia during the first 2 h after birth by means of blood analyses of hypoxanthine, lactate, base deficit, and pH was investigated in six infants with a 1 min Apgar score of less than or equal to 4. Reference values for the four biochemical variables were obtained in 16 healthy infants with a normal 1 min Apgar score of greater than or equal to 8. In the asphyxiated infants, elevated values for hypoxanthine were found in 48%, for lactate in 54%, and for base deficit in 46% while 21% of the pH values were lower than the reference. In the group of asphyxiated infants, significantly elevated hypoxanthine values were found during the first 20 min after birth, base deficit during 30 min, and lactate values during 120 min while lower pH values than the reference were found during the first 30 min. Significant correlations were found between hypoxanthine and lactate concentrations and also between hypoxanthine and base deficit but not between hypoxanthine and pH. It is concluded that the optimal time for detecting past intrauterine and 20 min after birth, but in individual cases, significantly increased hypoxanthine concentrations may be found at any time in the 10-120 min period. We propose an equation that can be used to calculate an upper normal limit for hypoxanthine concentration in any sampling time during this period.
对6名1分钟阿氏评分小于或等于4的婴儿，通过分析次黄嘌呤、乳酸、碱缺失和pH值来检测出生后最初2小时内既往缺氧情况的可能性进行了研究。在16名1分钟阿氏评分正常且大于或等于8的健康婴儿中获取了这四个生化变量的参考值。在窒息婴儿中，48%的次黄嘌呤值升高，54%的乳酸值升高，46%的碱缺失值升高，而21%的pH值低于参考值。在窒息婴儿组中，出生后最初20分钟内次黄嘌呤值显著升高，30分钟内碱缺失值显著升高，120分钟内乳酸值显著升高，而最初30分钟内pH值低于参考值。次黄嘌呤与乳酸浓度之间以及次黄嘌呤与碱缺失之间存在显著相关性，但次黄嘌呤与pH之间无显著相关性。结论是，检测既往宫内缺氧的最佳时间是出生后20分钟内，但在个别情况下，在10 - 120分钟期间的任何时间都可能发现次黄嘌呤浓度显著升高。我们提出了一个方程，可用于计算在此期间任何采样时间次黄嘌呤浓度的正常上限。
