主动脉弓离断新生儿的四肢血压和外周血氧饱和度的特点分析  

Profiles of four-limb blood pressures and saturation of peripheral oxygen in neonates with interrupted aortic arch

作　　者：邹瑞坤 孙云霞[1] 王一飞[1] 庄建[2] 陈燕玲[1] 刘玉梅[1] ZOU Rui-kun;SUN Yun-xia;WANG Yi-fei;ZHUANG Jian;CHEN Yan-ling;LIU Yu-mei(Guangdong Provincial People's Hospital,Guangdong Academy of Medical Sciences,Guangzhou 510100,China;Department of Cardiac Surgery,Guangdong Cardiovascular Institute,Guangdong Provincial People's Hospital,Guangdong Academy of Medical Sciences,Guangzhou 510100,China)

机构地区：[1]广东省人民医院(广东省医学科学院),广州510100 [2]广东省心血管病研究所心外科,广东省人民医院(广东省医学科学院),广州510100

出　　处：《岭南心血管病杂志》2020年第5期530-533,共4页South China Journal of Cardiovascular Diseases

基　　金：广东省科技计划项目(项目编号:2019B020230003)。

摘　　要：目的探讨先天性心脏病筛查中易漏诊的主动脉弓离断(interrupted aortic arch,IAA)新生儿的四肢血压和外周血氧饱和度(saturation of peripheral oxygen,SpO2)的特点。方法回顾性收集2013年至2019年在广东省人民医院诊断为IAA的新生儿四肢血压和SpO2数据,并分析其差别和特点。结果45例纳入分析的IAA患儿中,上肢收缩压明显高于下肢,差异有统计学意义[(74.8±12.0)vs.(66.1±12.0)mmHg,P=0.001;1 mmHg=0.133 kPa];但双侧肢体间收缩压比较,差异无统计学意义(P>0.05);四肢SpO2比较,差异无统计学意义(P>0.05)。19例(42.2%)患儿右上肢收缩压高于下肢超过10 mmHg,但有4例(8.9%)患儿存在粗大动脉导管未闭(PDA)和重度肺动脉高压,下肢收缩压高于右上肢。右上肢和右下肢SpO2<95%的患儿分别为15(33.3%)例和19(42.2%)例。其中,右上肢和右下肢SpO2差超过5%的患儿有6例(13.3%)。结论四肢血压存在差异提示患儿可能存在IAA,但四肢血压无差异不能排除IAA。SpO2不能单独作为筛查IAA的方法。Objectives To determine the profiles of four limbs blood pressures and saturation of peripheral oxygen(SpO2)in neonates with interrupted aortic arch(IAA).Methods Data of four limbs blood pressures and SpO2 in neonates with IAA admitted to Guangdong Provincial People's Hospital from 2013 to 2019 were retrospectively retrieved and analyzed.Results Among the 45 enrolled neonates,systolic blood pressures on upper limbs were statistically higher than those on lower limbs[(74.8±12.0)vs.(66.1±12.0)mmHg,P=0.001;1 mmHg=0.133 kPa].There were either no difference in blood pressures between right or left arm or limbs,or no difference in SpO2 among four limbs(P>0.05).Nineteen(42.2%)neonates presented with 10 mmHg higher of systolic blood pressures on right upper limbs than those on lower limbs.Four(8.9%)neonates with large patent ductus arteriosus and severe pulmonary arterial pressure pre⁃sented with higher lower limb systolic blood pressures.Fifteen(33.3%)and 19(42.2%)neonates presented with SpO2<95%on right arm and right lower limbs.Six(13.3%)neonates presented with SpO2 gradient more than 5%between right arm and lower limbs.Conclusions A high systolic blood pressure gradient on four limbs might lead to diagnosis of IAA,while IAA couldn't be excluded in neonates without systolic blood pressures gradient.SpO2 couldn't be solely used as a method to screen IAA.

关 键 词：主动脉弓离断 血压 外周血氧饱和度 新生儿 

分 类 号：R541.1[医药卫生—心血管疾病]