妊娠合并高铁血红蛋白血症罕见病例

The Rare Case of Pregnancy with Methemoglobinemia

高铁血红蛋白(methemoglobin, MetHb)是去氧或氧合血红蛋白血红素基团中的铁离子完全或部分从两价铁(Fe2+)被氧化为三价铁(Fe3+)而形成的血红蛋白的衍生物。高铁血红蛋白血症是一种罕见的疾病,主要以发绀(氧疗无效)、呼吸困难、头晕为常见临床表现,严重者可导致死亡。而且患者血液呈棕褐色,另一个重要的特征是低脉搏血氧饱和度(SpO2)与高动脉血氧饱和度(SaO2),5%以上的氧饱和度间隙应高度怀疑高铁血红蛋白血症。早期识别高铁血红蛋白血症并及时去除致病因素是关键。本文目的主要通过病例整理总结高铁血红蛋白血症的临床特点及诊治方法。本文报道西北妇女儿童医院MICU收治的妊娠合并高铁血红蛋白1例病例,查阅国内外相关文献,分析此病临床特点、发病机制及治疗方法。现对病例做如下报道。

Methemoglobin is a deriner of hemoglobin that has been oxidized from its ferrous (Fe2+) to ferric (Fe3+) in oxygen or oxygen hemoglobin hemorrin group. Methemoglobinemia is a rare disease, the common clinical manifestations are calamus (invalid oxygen therapy), difficulty breathing and diz-ziness, severe cases can lead to death. The blood of patients is tan, and another important feature is the low-pulse combination blood oxygen saturation (SpO2) and high arterial blood oxygen satura-tion (SaO2). The oxygen saturation gaps of more than 5% should be highly suspected of methemo-globinemia. The key to treatment is early recognition of methemoglobinemia and timely removal of pathogenic factor. The purpose of this article is to summarize the clinical characteristics and diag-nosis and treatment methods of methemoglobinemia through case analysis. This paper reports one case of pregnancy complicated with methemoglobin admitted to MICU of Northwest Women’s and Children’s Hospital, reviews relevant literature at home and abroad, analyzes the clinical character-istics, pathogenesis, and treatment methods of this disease. Report as follows.