Abstract：Objective Perinatal asphyxia is an important cause of brain injury, but an early prediction of outcome is still difficult. This paper aims to study the changes of lactate levels in plasma and cerebrospinal fluid (CSF) of neonates with hypoxic-ischemic encephalopathy (HIE) so as to explore the relationship between lactate levels and HIE as well as asphyxia. Methods Plasma lactate levels were measured in 26 neonates with HIE (8 mild, 10 moderate and 8 severe cases) and 8 healthy neonates at 0-24 hrs, 48-72 hrs and 7-10 days of their lives. CSF lactate levels were measured at 48-72 hrs of their lives and brain MRI examination was taken 7-10 days after birth in neonates with HIE. Results Plasma lactate levels in neonates with HIE and healthy neonates decreased daily after birth. The plasma lactate levels of the HIE neonates were significantly higher than those of the healthy ones at 0-24 hrs and 48-72 hrs of their lives. Plasma lactate levels in severe HIE neonates ( 9.11± 3.29 mmol/L) were higher than those of neonates with mild and moderate HIE ( 6.03± 2.66 and 6.56± 1.42 mmol/L) in the first day after birth (P< 0.05), but not in the following days. The CSF lactate levels in the severe HIE neonates ( 2.53± 0.27 mmol/L) were significantly higher than those in mild and moderate HIE ones ( 1.80± 0.20 and 1.91± 0.28 mmol/L) (P< 0.01). CSF lactate levels in the asphyxiated neonates whose 5 min Apgar score were less than 5 scores ( 2.43± 0.34 mmol/L) were higher than those whose Apgar scores were more than 5 ( 1.83± 0.25 mmol/L) (t= 5.22,P< 0.01). CSF lactate levels in HIE neonates with severe MRI abnormalities were higher than those with mild and moderate ( 2.36± 0.44 mmol/L vs 1.72± 0.24 mmol/L, 2.14± 0.26 mmol/L) (F= 7.15, P< 0.01). Conclusions The plasma lactate level may be associated with the degree of hypoxia only in the first 24 hrs of life. The CSF lactate level can reflect the severity of brain injury.
CHEN Ning,MAO Jian,WANG Xiao-Hong. Lactate levels in plasma and cerebrospinal fluid of neonates with hypoxic2ischemic encephalopathy[J]. CJCP, 2004, 6(6): 477-480.
