Deji Mei-duo, Shan Min-na, Zhang Yan-ling, Qun Yong, Zhao Min
Department of Pediatrics, People's Hospital of Tibet Autonomous Region, Lasa 850000, China.
Zhonghua Er Ke Za Zhi. 2011 Oct;49(10):793-5.
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.
From Jan. 2005 to Oct. 2006, totally 739 patients 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.
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.
The clinical characteristics, TcSO₂, 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.
分析新生儿缺氧与红细胞增多症之间的关系,并研究世居青藏高原的藏族新生儿和移居高原的汉族新生儿的临床特征。
2005年1月至2006年10月,共有739例患者在该医院新生儿科病房住院。其中,40例(藏族20例,汉族20例)患有新生儿红细胞增多症。对其临床特征、经皮血氧饱和度(TcSO₂)、外周血常规检查和心肌酶谱进行了研究。
汉族新生儿的血红蛋白(Hb)、血细胞比容(HCT)和红细胞计数(RBC)值显著高于藏族新生儿。汉族红细胞增多症新生儿的TcSPO₂低于藏族新生儿(P < 0.01)。心肌酶比较显示,汉族新生儿治疗前的CKMB高于藏族组(P < 0.01),汉族和藏族组治疗前肌钙蛋白无显著差异(P > 0.05)。汉族和藏族新生儿的主要共同临床表现为呼吸急促、发绀、易激惹、反射减弱和低氧血症。汉族新生儿还表现出反应差、呼吸暂停、肌张力降低、意识模糊和窒息。
临床特征、TcSO₂、外周血常规检查和心肌酶谱有助于新生儿红细胞增多症的诊断和治疗。移居高原地区母亲所生的新生儿可能更容易患新生儿红细胞增多症,且易出现其他器官功能损害,尤其是心脏和大脑的功能。