Objective: To explore the clinical value of arterial blood lactate level in predicting the prognosis of neonatal sepsis.
Methods: The clinical data of 301 cases of neonatal sepsis were collected, which mainly included biochemical indicators such as blood lactate on admission, C-reactive protein, and procalcitonin. ROC curves were plotted to evaluate the value of lactate level on admission in predicting the prognosis of neonatal sepsis.
Results: The mortality rate was significantly higher for full-term infants in the severely-elevated lactate group than in the mildly-elevated lactate group and the normal lactate group (26.1% vs 3.1% and 0%; P<0.017). The poor prognosis group had a significantly increased lactate level on admission compared with the good prognosis group (6.5±5.1 mmol/L vs 3.6±1.7 mmol/L; P<0.05). The sensitivity and specificity of blood lactate level on admission (cutoff value: 6.15 mmol/L) were 0.545 and 0.919 respectively, in predicting the prognosis of neonatal sepsis.
Conclusions: Early blood lactate level can be used as a biochemical parameter to predict the prognosis of neonatal sepsis as it has a high specificity but a low sensitivity.
目的: 探讨动脉血乳酸水平在判断新生儿败血症预后中的临床价值。
方法: 收集301例败血症新生儿的临床资料，主要包括入院时血乳酸、C反应蛋白、降钙素原等生化指标。通过ROC曲线分析，评估入院时血乳酸水平对判断新生儿败血症预后的价值。
结果: 足月儿血乳酸重度升高组病死率(26.1%)较轻度升高组(3.1%)和乳酸正常组(0%)明显升高(P < 0.017)。预后不良组入院时血乳酸水平(6.5±5.1 mmol/L)较预后良好组(3.6±1.7 mmol/L)明显升高(P < 0.05)。入院时血乳酸水平(临界值为6.15 mmol/L)对判断新生儿败血症预后的敏感性和特异性分别为0.545、0.919。
结论: 早期血乳酸水平可作为判断新生儿败血症预后的生化指标，特异性高，但敏感性较低。