Chou Y H, Tsou Yau K I, Wang P J
Division of Neonatology, Chang Gung Children's Hospital and Chang Gung Medical College, Taipei, Taiwan, ROC.
Acta Paediatr. 1998 Jul;87(7):764-8. doi: 10.1080/080352598750013851.
Lactate levels in combination with lactate/pyruvate (L/P) ratio have been used to measure altered cellular redox states. We measured the cord plasma lactate levels and L/P ratios in 70 normal neonates (40 full-term and 30 preterm neonates) to set up the normal (control) ranges. The control cord plasma lactate levels and L/P ratios were 2660 [700 (SD)] micromol/l, 16 (3) in full-term neonates and 2750 (740) micromol/l, 17 (3) in preterm neonates, respectively. We also measured the lactate levels and L/P ratios in the high-risk full-term (n = 23) and preterm (n = 35) neonates, the results were 4500 (2600) micromol/l, 19 (13), and 5100 (2700) micromol/l, 26 (12), respectively. With the aid of elevated lactate levels and L/P ratios, the occurrence of neonatal encephalopathy can be predicted with a sensitivity of 100% and a specificity of 94.5% in this patient group. In our study, the six cases with abnormal neurodevelopment at 6-9 months of age all had both elevated lactate levels and L/P ratios at birth. We conclude that the measurement of lactate levels in combination with L/P ratios is a useful quantitative tool in assessing the existence and severity of perinatal hypoxia in the high-risk neonates.
乳酸水平结合乳酸/丙酮酸（L/P）比值已被用于测量细胞氧化还原状态的改变。我们测量了70例正常新生儿（40例足月儿和30例早产儿）的脐血血浆乳酸水平和L/P比值，以建立正常（对照）范围。足月儿对照组脐血血浆乳酸水平和L/P比值分别为2660[700（标准差）]微摩尔/升、16（3），早产儿分别为2750（740）微摩尔/升、17（3）。我们还测量了高危足月儿（n = 23）和早产儿（n = 35）的乳酸水平和L/P比值，结果分别为4500（2600）微摩尔/升、19（13）和5100（2700）微摩尔/升、26（12）。借助升高的乳酸水平和L/P比值，在该患者组中预测新生儿脑病的发生，敏感性为100%，特异性为94.5%。在我们的研究中，6-9个月龄神经发育异常的6例患儿出生时乳酸水平和L/P比值均升高。我们得出结论，乳酸水平结合L/P比值的测量是评估高危新生儿围产期缺氧的存在和严重程度的一种有用的定量工具。
