【摘要】： 對新生兒進行臍血血氣分析在臨床上可以用來確切地反應(yīng)新生兒體內(nèi)的缺氧程度和酸堿失衡的情況，其中pH值，氧分壓，二氧化碳分壓等指標(biāo)國內(nèi)外報道的很多，可是鮮有關(guān)于堿剩余(BE)指標(biāo)的描述和報道。本論文的創(chuàng)新之處在于對新生兒臍靜脈血堿剩余正常參考值、臍動脈血堿剩余正常參考值與地理因素定量化研究。經(jīng)過檢索發(fā)現(xiàn)，只有一篇論文報道了新生兒臍血血氣分析與海拔高度的關(guān)系，但也只是定性描述，像本論文這樣對新生兒臍靜脈血堿剩余正常參考值、臍動脈血堿剩余正常參考值與地理因素進行專題化定量化研究，從整個地理環(huán)境著手，整體的研究中國這一大的區(qū)域，還未見有報道。 本文的醫(yī)學(xué)研究指標(biāo)就是選擇新生兒的臍動脈血堿剩余(BE)和臍靜脈血堿剩余(BE)，這兩項指標(biāo)都是判斷新生兒窒息中的重要指標(biāo)，通過對堿剩余(BE)和其他血氣分析指標(biāo)相結(jié)合的辦法對新生兒的缺氧狀況和酸堿中毒情況來進行判斷。探討中國新生兒臍動脈血堿剩余和臍靜脈血堿剩余兩項指標(biāo)與所選各種地理因素之間的關(guān)系，從而建立它們之間的回歸模型。 通過大量檢索文獻，以及向有關(guān)單位求購的方法，收集了全中國各地區(qū)新生兒臍動脈血堿剩余以及臍靜脈血堿剩余的正常參考值作為兩項醫(yī)學(xué)指標(biāo)。并根據(jù)有關(guān)地理著作和相關(guān)文獻，選取了七項地理因素指標(biāo)：海拔高度，年平均氣溫，年降水量，年日照時數(shù)，一月平均氣溫，七月平均氣溫，年平均相對濕度。將兩項醫(yī)學(xué)指標(biāo)分別與七項地理因素進行了直線回歸分析，逐步回歸分析，多元線性回歸分析以及非線性回歸分析，這樣得到了一系列回歸方程，依據(jù)最優(yōu)化原理，從得出的回歸方程中選出臍動脈血堿剩余，臍靜脈血堿剩余與各項地理因素之間的最優(yōu)回歸模型，利用得出的最優(yōu)回歸模型，選擇有代表性的地點，將利用模型估測出的預(yù)測值和從當(dāng)?shù)厮鸭降膶崪y值進行比較，利用單因素方差檢驗法對實測值與模型預(yù)測值的可信性進行驗證。最終發(fā)現(xiàn)實測值和模型預(yù)測值的一致性很好，可以利用該模型對各地的新生兒臍靜脈血堿剩余正常參考值、臍動脈血堿剩余正常參考值進行預(yù)測。 運用直線回歸分析，逐步回歸分析，多元線性回歸分析以及非線性回歸分析四種分析方法得出新生兒臍靜脈血堿剩余正常參考值、臍動脈血堿剩余正常參考值分別與各項地理因素之間的最優(yōu)回歸模型分別為：(?)_v=-2.034-0.285X_2+0.00814X_3-0.00120X_4+0.127X_5+0.156X_6±0.358F=79.420 P=0.000(?)_v的預(yù)測區(qū)間為[(?)_v-0.358，，(?)_v+0.358](?)_a=1.769-0.00296X_4±0.353F=1222.741，P=0．000(?)_A的預(yù)測區(qū)間為[(?)_a-0.353，(?)_a+0.353] 選取有代表性的地點進行估算和驗證，然后將所估算的預(yù)測值與當(dāng)?shù)氐膶崪y值進行比較，通過單因素方差法對預(yù)測值和實測值進行檢驗，發(fā)現(xiàn)利用模型估算出的預(yù)測值和實測值一致性很好，無顯著性差異(P＞0.05)。
[Abstract]:The analysis of umbilical blood gas analysis for newborns can be used to accurately reflect the condition of hypoxia and acid-base imbalance in the newborn, including pH value, oxygen partial pressure, carbon dioxide partial pressure and other indicators at home and abroad, but there are few descriptions and reports about the index of alkali residue (BE). The innovation of this paper lies in the new students. The residual normal reference value of umbilical vein blood base, the residual normal reference value of umbilical artery blood base and the quantitative study of geographical factors. After retrieval, only one paper reported the relationship between umbilical blood gas analysis and altitude, but it was also a qualitative description, like this paper, the normal reference value of the umbilical vein blood base in the newborn. The residual normal reference value of umbilical artery blood alkali and geographical factors are quantified and quantified. From the whole geographical environment, the overall study of this large area in China has not been reported.
The medical research index of this article is to select the umbilical artery blood alkali residue (BE) and the umbilical vein blood alkali residue (BE). These two indexes are all important indexes in judging the neonatal asphyxia. By combining the alkali remainder (BE) and other blood gas analysis indexes, the anoxia condition and acid-base intoxication of new born children are judged. To explore the relationship between the remaining two indexes of umbilical artery blood base and umbilical vein blood base and various geographical factors in Chinese neonates, and to establish a regression model between them.
Through a large number of retrieving literature and the method of seeking for the relevant units, the two medical indexes were collected from the umbilical artery blood alkali residue and the normal reference value of the umbilical vein blood base in all regions of China. According to the relevant geographical works and related literature, seven geographical factors were selected: altitude and annual average temperature, Annual precipitation, annual sunshine hours, average temperature of one month, average temperature in July and annual average relative humidity, two medical indexes and seven geographical factors were analyzed by linear regression analysis, stepwise regression analysis, multiple linear regression analysis and nonlinear regression analysis, which got a series of regression equations, according to the optimization principle, In the regression equation, the optimal regression model between umbilical artery blood alkali residue, umbilical vein blood alkali residue and various geographical factors is selected, and the optimal regression model is used to select the representative location, and the predicted values from the model are compared with the actual measured values collected locally, and the single factor variance test method is used. The dependability of the measured values and the predicted values of the model was verified. Finally, it was found that the consistency of the measured values and the predicted values of the model was very good. The model could be used to predict the residual normal reference value of umbilical vein blood base and the residual normal reference value of umbilical artery blood base.
By using linear regression analysis, stepwise regression analysis, multiple linear regression analysis and nonlinear regression analysis, four methods were used to obtain the residual normal reference value of neonatal umbilical vein blood base. The optimal regression model between the normal reference value of umbilical artery blood base and the geographical factors were respectively: (?) _v=-2.034-0.285X_2+0.00814X_3 The prediction interval of -0.00120X_4+0.127X_5+0.156X_6 + 0.358F=79.420 P=0.000 (?) _v is [(?) _v-0.358, (?) _v+0.358] (?) _a=1.769-0.00296X_4 + 0.353F=1222.741, P=0.000 (?) _A prediction interval is [(?) _a-0.353, (?) _a+0.353]
The estimated values are compared with the local measured values, and the predicted values and the measured values are tested by the single factor variance method. It is found that the predicted values of the model are in good agreement with the measured values, and there is no significant difference (P > 0.05).
【學(xué)位授予單位】：陜西師范大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2007
【分類號】：R722.1;R188

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