羊水中离子浓度与新生儿呼吸窘迫综合征相关性的临床研究
The relationship between ion concentrations in amniotic fluid and neonatal respiratory distress syndrome
袁昊 1彭湘莲 1李婷 1侯皓 1曾云清 1张腾伟 1房巧燕 1武周游 1陈北涛 1周利平1
作者信息
- 1. 湖南省妇幼保健院新生儿一科,长沙 410000
- 折叠
摘要
目的 探讨羊水中离子浓度与新生儿呼吸窘迫综合征(neonatal respiratory distress syndrome,NRDS)的相关性,为临床评估胎肺成熟、预测NRDS提供具有针对性、准确性及潜在价值的检测指标.方法 选择2022年1月至2022年12月在湖南省妇幼保健院出生并收治到新生儿一科的新生儿进行队列研究,分为NRDS组与非NRDS组,收集两组临床资料,采用血气分析仪测定羊水中K+、Na+、Cl-及Ca2+浓度,分析其与NRDS的相关性.结果 共纳入113例新生儿,NRDS组36例,非NRDS组77例.NRDS组胎龄、出生体重低于非NRDS组,产前激素使用、存在母孕期合并症比例高于非NRDS组,羊水Na+浓度(128.7±3.9)mmol/L高于非NRDS组(121.1+6.8)mmol/L,差异均有统计学意义(P＜0.05).两组羊水K+、Ca2+、Cl-浓度比较差异无统计学意义(P＞0.05).胎龄、出生体重与羊水Na+浓度是NRDS的独立危险因素,胎龄、出生体重与NRDS成负相关(β=-0.967、-2.299,P＜0.05);羊水Na+浓度与NRDS发生成显著正相关(β=0.634,P＜0.05);羊水K+、Cl-及Ca2+浓度与NRDS无相关性(P均＞0.05).采用受试者工作特征曲线预测NRDS的独立危险因素,发现羊水中Na+浓度为124.0 mmol/L时,曲线下面积为0.923,预测NRDS的敏感度为90.0％、特异度为80.0％.结论 羊水中Na+浓度与NRDS发生成显著正相关,羊水中K+、Ca2+、Cl浓度与NRDS无相关性;羊水中Na+浓度变化在预测NRDS方面具有非常高的诊断价值,当Na+浓度超过124.0 mmol/L,发生NRDS可能性大,可作为胎肺成熟的新型预警标志物.
Abstract
Objective To study the relationship between ion concentrations in amniotic fluid(AF)and neonatal respiratory distress syndrome(NRDS)and to find a targeted,accurate and potentially valuable indicator for clinical assessment of fetal lung maturation and prediction of NRDS.Methods From January 2022 to December 2022,neonates born in our hospital were assigned into NRDS group and non-NRDS group.The concentrations of potassium(K+),sodium(Na+),chloride(Cl-)and calcium(Ca2+)in AF were measured using blood gas analyzer and the relationship of these ions with NRDS were analyzed.Results A total of 113 neonates were enrolled,including 36 in NRDS group and 77 in non-NRDS group.NRDS group had a lower gestational age(GA)and birth weight(BW)than non-NRDS group,higher rate of antenatal corticosteroid use,maternal-pregnancy comorbidities and Na+concentration in AF[(128.7±3.9)vs.(121.1±6.8)mmol/L]than non-NRDS group(all P＜0.05).No significant differences existed in K+,Ca2+and Cl-concentrations in AF between the two groups.GA,BW and Na+concentration in AF were independent risk factors for NRDS.GA and BW were negatively correlated with NRDS(β=-0.967,-2.299,P＜0.05),Na+concentration in AF was positively correlated with NRDS(β=0.634,P＜0.05).K+,Ca2+and Cl-concentrations in AF were not correlated with NRDS(all P＞0.05).Receiver operating characteristic curve was used to determine the independent risk factor for NRDS and area under the curve was found to be 0.923 with Na+concentration in AF of 124.0 mmol/L,with a sensitivity of 90.0％and a specificity of 80.0％for predicting NRDS.Conclusions The Na+concentration in AF is positively correlated with the occurrence of NRDS,while K+,Ca2+and Cl-in AF are not correlated with NRDS.The possibility NRDS is quite high when Na+concentration is more than 124.0 mmol/L.It can be used as an early indicator for fetal lung maturation.
关键词
羊水/钾离子/钠离子/氯离子/钙离子/新生儿呼吸窘迫综合征Key words
Amniotic fluid/Potassium ion/Sodium ion/Chloride ion/Calcium ion/Neonatal respiratory distress syndrome引用本文复制引用
基金项目
湖南省卫生健康委科研计划项目(202206033500)
湖南省母源性新生儿疾病临床医学研究中心(2023SK4057)
出版年
2024
NETL
NSTL
万方数据