紫绀型先天性心脏病患者血红蛋白增高的临床意义

Clinical significance of high hemoglobin in patients with cyanotic congenital heart disease

目的：探讨紫绀型先天性心脏病（CHD）患者血红蛋白增高的临床意义。方法：将91例紫绀型CHD按血红蛋白值随机分为A组（180-200g/L）、B组（200-220g/L）及C组（〉220g/L）,分析各组临床病理数据之间的相关性。结果：在血红蛋白增高患者中原发病为肺血减少型先天性心脏病的占81.32%。法洛四联症患者McGoon值与血红蛋白计数呈正性相关（P〈0.01）。A组体-肺侧支阳性例数较C组高（P〈0.01）。血红蛋白计数与红细胞压积、凝血酶原时间和国际化标准值呈正性线性关系（P〈0.01）,与血小板计数呈负性线性关系（P〈0.01）。19例患者尿蛋白异常,占21.11%,3组间尿蛋白检测结果无差异（P〉0.05）。结论：紫绀型先天性心脏病患者血红蛋白增高与原发病、肺血管和侧支情况有关,可伴有血液系统、凝血功能和肾功能异常。

Objective：To discuss the clinical significance of high hemoglobin（HGB）in patients with cyanoticcongenital heart disease（CHD）.Methods：Ninety-one patients with cyanotic CHD were randomly divided into group A（HGB 180-200g/L）,B（HGB 200-220g/L）and C（HGB〉220g/L）.The clinicopathologic data were statistically analyzed among three groups.Results：Congenital heart disease with diminutive pulmonary blood flow was the main primary disease for high hemoglobin,accounted for 81.32%.Positive correlation between McGoon value and hemoglobin in TOF patients was confirmed（P〈0.01）.Compared with group C,patients in group A had higher positive rate of aorto-pulmonary collateral arteries（APCAs）（P〈0.05）.There was positive linear correlation between hemoglobin and HCT,PT and INR（P〈0.01）and negative linear correlation between hemoglobin and PLT（P〈0.01）.Nineteen patients were diagnosed as proteinuria,accounted for 21.11%,and there was no statistical difference in urinalysis among three groups（P〉0.05）.Conclusion：The high hemoglobin in cyanotic CHD patients may be related with primary disease,pulmonary vessels and APCAs,probably with abnormal coagulation,hematopoietic system and renal function.