不同海拔地区新生儿脉搏血氧饱和度分布的差异  

The distribution and variance of neonatal pulse oxygen saturation at different altitudes

作　　者：田友平 胡晓静[1] 马晓静[1] 顾青[1] 葛小玲[1] 杨杪 贾品[1] 黄国英[1] Tian Youping;Hu Xiaojing;Ma Xiaojing;Gu Qing;Ge Xiaoling;Yang Miao;Jia Pin;Huang Guoying(Children′s Hospital of Fudan University,Shanghai 201102)

机构地区：[1]复旦大学附属儿科医院新生儿先心病筛查国家级项目管理办公室,上海201102

出　　处：《中华医学杂志》2021年第19期1410-1414,共5页National Medical Journal of China

基　　金：国家重点研发计划(2016YFC1000506);中国医学科学院创新单元(2018RU002)。

摘　　要：目的分析我国不同海拔地区新生儿脉搏血氧饱和度(SpO2)的分布,为不同海拔地区新生儿先天性心脏病(NCHD)筛查提供参考依据。方法基于国家NCHD筛查项目数据库,描述0~100 m、600~700 m、900~1100 m、1400~1600 m、1900~2100 m和2200~2500 m海拔地区26766名新生儿SpO2的分布,并采用单因素方差分析比较不同海拔地区新生儿SpO2的差异。结果0~100 m、600~700 m、900~1100 m、1400~1600 m、1900~2100 m和2200~2500 m海拔地区新生儿右手的SpO2分别为97.7%±1.4%、97.1%±1.1%、96.1%±1.3%、96.0%±1.7%、95.9%±1.7%和95.5%±2.4%,任意一足的均SpO2分别为97.7%±1.4%、96.9%±1.1%、96.3%±1.4%、96.0%±1.7%、95.6%±1.8%和95.2%±2.7%。不同海拔地区间新生儿的平均SpO2值两两比较差异均有统计学意义(右手:F=1248.35,P<0.001;任意一足:F=1280.45,P<0.001)。随着海拔高度的升高,新生儿右手和任意一足的SpO2呈线性降低趋势(均P-trend<0.001)。结论随着海拔的升高,新生儿SpO2呈降低趋势,提示目前基于海平面地区SpO2的NCHD筛查阈值范围可能不适用于更高海拔地区的新生儿。Objective To analyze the distribution and variance of neonatal pulse oxygen saturation(SpO2)at different altitudes in China,and provide a new evidence for the screening of NCHD at high altitudes.Methods Based on the database of National Screening Project of NCHD,the distribution of SpO2 values was described in 26766 newborns at altitudes of 0-100 m,600-700 m,900-1100 m,1400-1600 m,1900-2100 m,and 2200-2500 m.One-way analysis of variance was used to analyze the differences among SpO2 values in newborns at different altitudes.Results The average SpO2 values of right hand in newborns at altitudes of 0-100 m,600-700 m,900-1100 m,1400-1600 m,1900-2100 m and 2200-2500 m were 97.7%±1.4%,97.1%±1.1%,96.1%±1.3%,96.0%±1.7%,95.9%±1.7%and 95.5%±2.4%,respectively.And corresponding average SpO2 values of either foot were 97.7%±1.4%,96.9%±1.1%,96.3%±1.4%,96.0%±1.7%,95.6%±1.8%and 95.2%±2.7%,respectively.There were statistically significant differences in the average SpO2 values of newborns at different altitudes(right hand:F=1248.35,P<0.001;either foot:F=1280.45,P<0.001).The SpO2 of newborns tended to be lower with the increase of altitudes(P-trend<0.001).Conclusion SpO2 values in newborns were negatively associated with the altitudes,which indicated that the cut‐off value of screening for NCHD at sea level might not be applicable to newborns at higher altitudes.Thus,it is worthwhile to conducted studies on the normal values of SpO2 and the cut‐off value of screening for NCHD in newborns at high altitudes.

关 键 词：新生儿筛查 血氧测定法 高海拔 心脏缺损 先天性 

分 类 号：R722.1[医药卫生—儿科]