新生儿自主呼吸时鼻前庭内呼气末二氧化碳分压与动脉血二氧化碳分压的相关性

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摘要 [摘要] 目的了解新生儿自主呼吸时鼻前庭内呼气末二氧化碳分压（PetCO2）与动脉血二氧化碳分压（PaCO2）相关性。方法选取2014年5月~2015年7月扬州大学医学院附属淮安市妇幼保健院新生儿医学中心住院的自主呼吸新生儿85例，在生后6~24 h内测定新生儿鼻前庭内PetCO2，同时进行动脉血气分析获取PaCO2。根据孕龄将新生儿分为早产儿组（39例）、足月组（46例）；根据有无呼吸系统疾病分为呼吸疾病组（25例）和无呼吸疾病组（60例）。采用t检验进行比较，采用Pearson双变量相关性分析判断PetCO2与PaCO2的相关性。结果所有入选新生儿平均PetCO2[（37.6±6.3）mmHg]（1 mmHg=0.133 kPa）低于平均PaCO2[（40.2±7.4）mmHg]，差异有统计学意义（t = 2.406，P = 0.017），PetCO2与PaCO2呈正相关（r = 0.947，P = 0.000）。早产儿组PetCO2低于PaCO2，差异无统计学意义（t = 1.314，P = 0.193）；足月儿组PetCO2低于PaCO2，差异有统计学意义（t = 2.032，P = 0.045）。呼吸疾病组PetCO2[（40.1±6.2）mmHg]低于PaCO2[（45.0±7.6）mmHg]，差异有统计学意义（t = 2.494，P = 0.016）；而无呼吸疾病组PetCO2[（36.6±6.1）mmHg]低于PaCO2[（38.4±6.2）mmHg]，差异无统计学意义（t = 1.368，P = 0.174）；呼吸疾病组新生儿PetCO2与PaCO2相关性（r = 0.920，P = 0.000）较无呼吸疾病组新生儿低（r = 0.980，P = 0.000）。呼吸疾病组动脉血-呼气末二氧化碳分压的差值[P（a-et）CO2，（4.9±2.1）mmHg]高于无呼吸疾病组[（1.8±0.8）mmHg]，差异有高度统计学意义（t = 9.901，P = 0.000）。结论新生儿自主呼吸时鼻前庭内PetCO2水平可预测PaCO2水平，当新生儿无呼吸疾病时准确性更高，具有临床实用价值。

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	马丙送1
	2 孙佃军1 高子波1 胡金绘1 花少栋3 武荣1▲

关键词 ： [关键词] 新生儿, 鼻前庭, 呼气末二氧化碳分压, 动脉血二氧化碳分压

Abstract：[Abstract] Objective To understand the correlation between end-tidal carbon dioxide partial pressure (PetCO2) and arterial partial pressure of carbon dioxide (PaCO2) in nasal vestibule of spontaneously breathing neonates, and verify the reliability of PetCO2 in reflecting PaCO2 in spontaneously breathing neonates. Methods From May 2014 to July 2015, 85 spontaneously breathing hospitalized neonates were randomly selected in Neonatal Medical Center of Huai'an Maternity and Child Healthcare Hospital Affiliated to Yangzhou University Medical Academy. PetCO2 values in nasal vestibule were recorded, while extracting radial arterial for blood gas analysis. According to gestational age, neonates were divided into preterm group (39 cases) and term infant group (46 cases); according to the presence of respiratory system disease, neonates were divided into respiratory disease group (25 cases) and without respiratory disease group (60 cases). PaCO2 and PetCO2 levels were compared by t test and correlated using Pearson correlation. Results The overall average mean value of PetCO2 was lower than that of PaCO2 [(37.6±6.3) vs (40.2±7.4) mmHg, t = 2.406, P = 0.017] (1 mmHg=0.133 kPa). There was a good correlation between PetCO2 and PaCO2 levels among all paired samples (r = 0.947, P = 0.000). PetCO2 of the preterm group was lower than PaCO2, there was no statistically significant difference (t = 1.314, P = 0.193). PetCO2 of the term infant group was lower than PaCO2, the difference was statistically significant (t = 2.032, P = 0.045). The difference between PetCO2 and PaCO2 levels was significant only in the respiratory disease group [(40.1±6.2) vs (45.0±7.6) mmHg, t = 2.494, P = 0.016], but not in the without respiratory disease group [(36.6±6.1) vs (38.4±6.2) mmHg, t = 1.368, P = 0.174]. The correlation between PetCO2 and PaCO2 in the respiratory disease group (r = 0.920, P = 0.000) was lower than that in the without respiratory disease group (r = 0.980, P = 0.000). The difference of PaCO2 and PetCO2 [P(a-et)CO2] in the respiratory disease group [(4.9±2.1) mmHg] was higher than that of the without respiratory disease group [(1.8±0.8) mmHg], and the difference was statistically significant (t = 9.901, P = 0.000). Conclusion PetCO2 of nasal vestibule can provide an accurate and noninvasive estimate of PaCO2 levels in spontaneously breathing neonates, especially in the neonates without respiratory disease.

Key words： [Key words] Neonate Nasal vestibule End-tidal carbon dioxide partial pressure Arterial partial pressure of carbon dioxide

基金资助:[基金项目] 江苏省淮安市重点研发计划（社会发展）项目（HAS2015004）。

通讯作者: ▲通讯作者

作者简介: [作者简介] 马丙送（1981.11-），男，扬州大学医学院2013级儿科专业在读硕士研究生；研究方向：新生儿疾病诊治。

引用本文:

马丙送1，2 孙佃军1 高子波1 胡金绘1 花少栋3 武荣1▲. 新生儿自主呼吸时鼻前庭内呼气末二氧化碳分压与动脉血二氧化碳分压的相关性[J]. 中国医药导报, 2016, 13(3): 106-109.
MA Bingsong1,2 SUN Dianjun1 GAO Zibo1 HU Jinhui1 HUA Shaodong3 WU Rong1▲. Correlation between end-tidal carbon dioxide partial pressure and arterial partial pressure of carbon dioxide in nasal vestibule of the spontaneously breathing neonates. 中国医药导报, 2016, 13(3): 106-109.

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