【摘要】 目的比较新生儿良性和非良性心律失常的临床特点。方法回顾性分析317例心律失常新生儿的临床资料,根据临床表现、心电图或Holter监测结果将患儿分为良性心律失常组和非良性心律失常组。总结两组心律失常的常见类型,并比较两组的一般资料和病史资料、实验室检查结果及预后。结果 317例心律失常新生儿中,271例为良性心律失常,46例为非良性心律失常。良性心律失常的最常见类型为房性期前收缩、室性期前收缩合并房性期前收缩、室性期前收缩;非良性心律失常的最常见类型为心房扑动、房室传导阻滞、阵发性室上性心动过速。与良性心律失常组相比,非良性心律失常组早产率更高,阴道分娩率、出生后1 min Apgar评分正常率、产前胎心监测正常率更低,肌酸激酶同工酶水平以及钠离子、氯离子、钾离子、镁离子的异常率均更高,住院天数更长,死亡率更高(均P<0.05)。结论良性和非良性新生儿心律失常在母体因素、生化指标等方面存在差异,这或有助于早期鉴别新生儿心律失常的类型;非良性新生儿心律失常需要积极干预,以提高新生儿的存活率。更多还原

【Abstract】 Objective To compare the clinical characteristics between benign and non-benign arrhythmia in neonates.Methods The clinical data of 317 neonates diagnosed with arrhythmia were analyzed retrospectively.The neonates were divided into benign arrhythmia group and non-benign arrhythmia group according to their clinical manifestations and electrocardiogram/Holter monitoring results,then the common types of arrhythmia were summarized in the two groups;besides,the general and history data,laboratory test results and prognosis were compared between the two groups.Results Among the 317 arrhythmia neonates,271 had benign arrhythmia and 46 had non-benign arrhythmia.The most common types of benign arrhythmia were premature atrial contraction,premature ventricualr contraction complicated with premature atrial contraction,and premature ventricular contraction;the most common types of non-benign arrhythmia were atrial flutter,atrioventricular block,and paroxysmal supraventricular tachycardia.Compared with the benign arrhythmia group,the non-benign arrhythmia group possessed a higher preterm birth rate,and lower virginal delivery rate,lower rate of normal Apgar score at one minute after birth,lower rate of normal prenatal fetal heart monitoring,and a higher level of creatine kinase-MB isoenzyme,as well as higher rates of abnormal sodium ion,chloride ion,potassium ion and magnesium ion,longer hospital stay and higher case fatality rate(all P<0.05).Conclusion Differences in maternal factors and biochemical indicators exist between benign and non-benign arrhythmias in neonates,which may be beneficial to early identification of neonatal arrhythmia type; active treatment should be performed in non-benign neonatal arrhythmia,thus improving neonatal survival rate.更多还原