新生儿G6PD缺陷病和晚发性维生素K缺乏症的特点与预防

A Study on the characterization and prevention of glucose-6-phosphate dehydrogenase(G6PD) in the newborn and delayed vitamin K deficiency

目的 探讨新生儿G6PD缺陷病和晚发性维生素K缺乏症的危害与预防措施。方法 回顾分析 1995～ 2 0 0 0年儿内科住院的 1周～ 2月 (不含 2月 )的婴儿 310 4例次 ,其中病死 5 6例。结果 1周～ 2月的小婴儿占住院患儿的19 34% ,其中新生儿C6PD缺陷病 2 39例 ,占 7 70 % ;晚发性维生素K缺乏症 92例 ,占 2 96 %。死因的第 2、3位分别是晚发性维生素K缺乏症 (13例 ,占 2 3 2 1% )和新生儿G6PD缺陷病 (12例 ,占 2 1 4 3% ) ,两者的病死率分别为 14 13%和 5 0 2 % ,极显著高于 (χ2 =17 5 9,P <0 0 1)或相近于 (χ2 =0 88,P >0 0 5 )肺炎的 3 5 7%。新生儿C6PD缺陷病合并感染占 38 4 9%、低氧血症占 2 3 35 %、低血糖占 19 2 5 %、酸中毒占 15 90 % ,继发胆红素脑病占 13 81%。晚发性维生素K缺乏症出现抽搐占90 2 2 %、胃肠、注射部位出血占 6 0 89% ;CT证实颅内出血占 98 91%。结论 1周～ 2月的小婴儿约占住院患儿的两成 ,新生儿C6PD缺陷病和晚发性维生素K缺乏症的病死率均很高 ,两者是除肺炎外最主要的死因。提议制定并推广预防这 2种疾病的常规措施 ,并参照国内外相应的现状拟出其具体内容。

Objective:To explore the feature and preventive measures of G6PD in the newborn and delayed vitamin K deficiency.Methods:From l995-2000,3 104 cases of infants,1 week-2 months(except for 2 months)old,were hospitalized in pediatrics.Of which 56 cases had dead.The case reports were andlyzed retrospectively.Results:The 3 104 Cases of infants accounted for 19.34% in all infants hospitalized in pediatrics at the same time.239 cases suffered from G6PD of the newborn,accounted for 7.70%.92 cases suffered from delayed vitamin K deficiency.The second and third causes of death were delayed vitamin K deficiency(13 cases,accounted for 23.21%)and G6PD of the newborn (12 cases,accounted for 21.43%).The death rate of the former was 14.13%,more than that of the pneumonia(3.57%,χ 2=17.59,P<0.01)signifilcantly.The death rate of the latter was 5.02%,as same as that of the pneumonia(χ 2=0.88,P>0.05).The G6PD of the newborn complicated infection,meionectic blood,hypoglycemia,acidosis and bilirubin encephalopathy accounted for 38.49%,23.35%,19.25%,15.90% and l3.81% respectively.The seizure,gastrointestional bleeding or bleeding caused by injection and intracranial haemorrhage confirmed by CT in delayed vitamin K deficiency accounted for 90.22%,60.89% and 98.81% respectively.Conclusions The death rate of delayed vitamin K deficiency and G6PD of the newborn was higher.They were the second and third causes of death in that infants age from 1 week to 2 months.It is suggested to take measure to prevent the two diseases.The preventive program has made according to the literature.and the treatment of the two diseases in our hospital.