红细胞增多症与多器官功能损害的临床探讨

Relationship between neonatal polycythemia vera and multi-organ failure

目的探讨新生儿红细胞增多症与多器官功能损害的关系及发生率。方法对资料完整的新生儿红细胞增多症96例的临床表现、肝功、胆红素、肾功、心肌酶谱、血糖、心电图、CT检查结果等资料进行分析。结果临床表现以多血貌、黄疸、神经系统及原始反射异常多见。肝功损害以GGT增高较为明显(占85.4%),GGT增高与胆红素增高有相关性。ALT增高较少(占16.7%)。心肌酶谱异常以A ST、CK、CK-M B为主。血糖异常27.1%,低钙血症35.4%,高磷血症69.7%。肾功能检查BUN异常27.1%,C r异常25.0%。心电图改变以ST-T改变为主;其次为心律改变。CT颅内低密度改变50.2%,出血4.0%。96例中同时有心、脑、肝、肾损害27.8%;同时有2个以上器官损害85.4%。结论新生儿红细胞增多症易引起多器官功能损害,且发生率较高。

[Objective]To approach the relationship between neonatal polycythemia vera （PV）and multiorgan failure（MOF）, and the incidence of MOF. [Methods] Observed the clinical manifestations of 96 cases of neonatal PV cases with entire data and analyzing their monitor hepatic function, bilirubin, renal function, myocardial zymogram, blood glucose, electrocardiogram （ECG） and craniocerebral CT. [Results]The frequent signs and symptoms included plethora （89.6 %）, nerve system ailment （86.5 % ）, abnormal primitive reflex （70. 1% ）, tachypnea （65.6 % ）, cardiac rhythm changes （ 76.0 % ）, jaundice （85.4 % ）, cyanosis （47.9 % ）and abdominal distention （11.5 % ）. The findings included abnormal myocardial zymogram（89.3 %）, changes of ECG （26.1% ）, abnormal renal function （29.2 % ）, abnormal liver function （85.4 %）, craniocerebral CT with low radiopacity （54. 2 % ）, intracranial hemorrhage （8.3 % ）, hypoglycemia （ 18.8 % ）, hyperglycemia （8. 3 % ） and hyperbilirubinemia （81. 3%）. Of the 96 polycythemic infants, 27. 8% had combined damages of heart, brain, liver and kidney simultaneously, and 85. 4% had combined damages of more than two organs simultaneously. [Conclusion] Neonatal PV results in MOF easily, and the incidence is high.