中华儿科杂志
中華兒科雜誌
중화인과잡지
Chinese Journal of Pediatrics
2011年
10期
793-795
,共3页
德吉美朵%扇敏娜%张雁玲%群勇%赵敏
德吉美朵%扇敏娜%張雁玲%群勇%趙敏
덕길미타%선민나%장안령%군용%조민
婴儿,新生%高原病%红细胞增多症%藏族%汉族%心肌疾病
嬰兒,新生%高原病%紅細胞增多癥%藏族%漢族%心肌疾病
영인,신생%고원병%홍세포증다증%장족%한족%심기질병
Infant,newborn%Altitude sickness%Polycythemia%Zang nationality%Hannationality%Cardiomyopathies
目的 分析高海拔地区新生儿缺氧与红细胞增多症的关系,对高原世居藏族新生儿与移居高原汉族新生儿临床特点进行研究.方法 2005年1月1日至2006年10月31日,我院新生儿病房收治的739例患儿.对其中资料完整符合新生儿红细胞增多症者40例(其中藏族20例,汉族20例)进行了临床特点、检测经皮氧饱和度( TcSP02)、末梢血常规[血红蛋白(Hb)、红细胞(RBC)、红细胞压积(HCT)]和心肌酶谱研究分析.结果 汉族新生儿Hb为26.72±3.25、HCT为0.684±0.051、RBC为7.63±1.98三项值明显高于藏族新生儿的24.89±1.76、HCT 0.678±0.045、6.89±1.72,P≤0.05.汉族新生儿红细胞增多症者TcSP02浓度较藏族新生儿低82±5.882,P≤0.05,差异有统计学意义；汉族新生儿红细胞增多症患者末梢血常规血红蛋白(Hb)、红细胞( RBC)、红细胞压积(HCT)水平高于藏族新生儿,P≤0.05,藏族新生儿红细胞增多症末梢血常规血Hb、RBC、HCT治疗后均降至正常水平；心肌酶谱检测结果汉族组肌酸激酶同工酶( CKMB)治疗前与藏族组比较,F=171.41、P＜0.01,肌钙蛋白汉族组治疗前与藏族组比较,F=2.31、P＞0.01.肌红蛋白汉族组治疗前与藏族组比较,差异有统计学意义F=60.06、P＜0.01.藏汉族两组共同临床特征:呼吸急促,发绀、多血质外貌,易激惹、反射弱、低氧血症为主.缺氧为诱发因素；汉族组临床除以上共同特征外、以反应差、呼吸暂停、肌张力低下、神志淡漠、窒息为主要特征.40例新生儿红细胞增多症以低氧血症和心肌受损为主要表现.结论 高原新生儿红细胞增多症临床特征、TcSP02、末梢血常规和心肌酶谱变化特征对于指导新生儿红细胞增多症诊断治疗有一定的临床意义.移居高原者在高海拔地区更易发生新生儿红细胞增多症,且易导致其他器官,尤其是心脑功能受损.
目的 分析高海拔地區新生兒缺氧與紅細胞增多癥的關繫,對高原世居藏族新生兒與移居高原漢族新生兒臨床特點進行研究.方法 2005年1月1日至2006年10月31日,我院新生兒病房收治的739例患兒.對其中資料完整符閤新生兒紅細胞增多癥者40例(其中藏族20例,漢族20例)進行瞭臨床特點、檢測經皮氧飽和度( TcSP02)、末梢血常規[血紅蛋白(Hb)、紅細胞(RBC)、紅細胞壓積(HCT)]和心肌酶譜研究分析.結果 漢族新生兒Hb為26.72±3.25、HCT為0.684±0.051、RBC為7.63±1.98三項值明顯高于藏族新生兒的24.89±1.76、HCT 0.678±0.045、6.89±1.72,P≤0.05.漢族新生兒紅細胞增多癥者TcSP02濃度較藏族新生兒低82±5.882,P≤0.05,差異有統計學意義；漢族新生兒紅細胞增多癥患者末梢血常規血紅蛋白(Hb)、紅細胞( RBC)、紅細胞壓積(HCT)水平高于藏族新生兒,P≤0.05,藏族新生兒紅細胞增多癥末梢血常規血Hb、RBC、HCT治療後均降至正常水平；心肌酶譜檢測結果漢族組肌痠激酶同工酶( CKMB)治療前與藏族組比較,F=171.41、P＜0.01,肌鈣蛋白漢族組治療前與藏族組比較,F=2.31、P＞0.01.肌紅蛋白漢族組治療前與藏族組比較,差異有統計學意義F=60.06、P＜0.01.藏漢族兩組共同臨床特徵:呼吸急促,髮紺、多血質外貌,易激惹、反射弱、低氧血癥為主.缺氧為誘髮因素；漢族組臨床除以上共同特徵外、以反應差、呼吸暫停、肌張力低下、神誌淡漠、窒息為主要特徵.40例新生兒紅細胞增多癥以低氧血癥和心肌受損為主要錶現.結論 高原新生兒紅細胞增多癥臨床特徵、TcSP02、末梢血常規和心肌酶譜變化特徵對于指導新生兒紅細胞增多癥診斷治療有一定的臨床意義.移居高原者在高海拔地區更易髮生新生兒紅細胞增多癥,且易導緻其他器官,尤其是心腦功能受損.
목적 분석고해발지구신생인결양여홍세포증다증적관계,대고원세거장족신생인여이거고원한족신생인림상특점진행연구.방법 2005년1월1일지2006년10월31일,아원신생인병방수치적739례환인.대기중자료완정부합신생인홍세포증다증자40례(기중장족20례,한족20례)진행료림상특점、검측경피양포화도( TcSP02)、말소혈상규[혈홍단백(Hb)、홍세포(RBC)、홍세포압적(HCT)]화심기매보연구분석.결과 한족신생인Hb위26.72±3.25、HCT위0.684±0.051、RBC위7.63±1.98삼항치명현고우장족신생인적24.89±1.76、HCT 0.678±0.045、6.89±1.72,P≤0.05.한족신생인홍세포증다증자TcSP02농도교장족신생인저82±5.882,P≤0.05,차이유통계학의의；한족신생인홍세포증다증환자말소혈상규혈홍단백(Hb)、홍세포( RBC)、홍세포압적(HCT)수평고우장족신생인,P≤0.05,장족신생인홍세포증다증말소혈상규혈Hb、RBC、HCT치료후균강지정상수평；심기매보검측결과한족조기산격매동공매( CKMB)치료전여장족조비교,F=171.41、P＜0.01,기개단백한족조치료전여장족조비교,F=2.31、P＞0.01.기홍단백한족조치료전여장족조비교,차이유통계학의의F=60.06、P＜0.01.장한족량조공동림상특정:호흡급촉,발감、다혈질외모,역격야、반사약、저양혈증위주.결양위유발인소；한족조림상제이상공동특정외、이반응차、호흡잠정、기장력저하、신지담막、질식위주요특정.40례신생인홍세포증다증이저양혈증화심기수손위주요표현.결론 고원신생인홍세포증다증림상특정、TcSP02、말소혈상규화심기매보변화특정대우지도신생인홍세포증다증진단치료유일정적림상의의.이거고원자재고해발지구경역발생신생인홍세포증다증,차역도치기타기관,우기시심뇌공능수손.
Objective To analyze the relationship between neonatal hypoxia and polycythemia and to study clinical characteristics of Tibetan neonates whose family lived in Tibetan plateau for generations and Han neonates whose family moved to the plateau.Method From Jan.2005 to Oct.2006,totally 739patients were hospitalized in the ward of neonatology of the hospital.Of these patients,40 (20 were Tibetan and the other 20 were Han ) with neonatal polycythemia.The clinical features,transcutaneous oxygen saturation (TcSO2 ),peripheral routine tests and myocardial enzyme profile were studied.Result The values of hemoglobin (Hb),hematocrit (HCT),and erythrocyte count (RBC) of the Han neonates were significantly higher than those of the Tibetan newborns.Han neonates with polycythemia had lower TcSPO2 than Tibetan neonates (P ＜0.01 ).Comparison of myocardial enzymes showed that Han neonates had higher CKMB than that of Tibetan groups before treatment ( P ＜ 0.01 ),troponin was not significantly different between the Han and Tibetan groups before treatment ( P ＞ 0.05 ).The major common clinical manifestations of the Han and Tibetan newborns were tachypnea,cyanosis,irritability,weak reflexes and hypoxemia.The Han neonates additionally had poor responses,apnea,lower muscle tone,confusion and asphyxia.Conclusion The clinical characteristics,TcS02,peripheral blood routine tests and myocardial enzyme profile are helpful in diagnosis and treatment of neonatal polycythemia.Newborn infants born to mothers who moved to the plateau area may be more susceptible to neonatal polycythemia and are prone to impairments of other organs,esp.the functions of the heart and brain.
