新生儿心律失常15例临床分析

新生儿心律失常有其自身特点,在临床上并不少见,越来越引起新生儿医师的重视。现将我科2005年12月至2006年12月收治的新生儿心律失常15例临床特点分析如下。资料与方法一、一般资料2005年12月至2006年12月我科住院经心脏听诊、心电监护或产前检查提示诊断的心律失常新生儿15例,男10例,女5例;足月儿9例,早产儿6例;胎龄最小33周,最大40周;体重>2500g8例,1500～2500g7例;心律失常由心脏听诊发现5例,心电监护时发现8例,产前检查时发现2例。二、病因及临床表现窒息缺氧7例,感染4例,先天性心脏病2例,病毒性心肌炎1例,电解质紊乱1例。临床症状大多…     

重症监护病房新生儿心律失常的临床特点及预后

目的探讨新生儿重症监护病房(NICU)中新生儿心律失常的临床特点及预后。方法对本院NICU 2007年7月至2011年1月收治的心律失常新生儿资料进行回顾性分析,结性或交界性心律、房性早搏和室性早搏为良性心律失常组,室上性快速心律失常、Ⅱ度Ⅱ型以上窦房传导阻滞、Ⅱ度以上房室传导阻滞和室性心动过速为非良性心律失常组,总结两组患儿的临床特点及预后。结果 48例心律失常新生儿,其中男32例,女16例;足月儿37例,早产儿11例。心律失常以非良性心律失常占多数,共36例(75.0%),均有临床表现,其中12例(25.0%)入院时即存在呼吸、循环衰竭;感染、缺氧、器质性心脏病、电解质紊乱及酸碱失衡为主要高危因素;心律失常类型以快速心律失常为主,共30例(83.3%)。良性心律失常多无症状,经病因治疗或抗心律失常治疗均痊愈或好转,非良性心律失常中死亡4例,未愈3例。结论 NICU新生儿心律失常中非良性心律失常相对较多,多数有临床表现,且需及时治疗,预后与原发病及心律失常类型有关,室上性心律失常相对预后好,室性心律失常预后差。     

新生儿心律失常的诊断与治疗

目的：探讨新生儿心律失常在新生儿中的发病情况及临床特点。方法：分析该科收治的23例新生儿心律失常的临床特点及治疗转归。结果：该组新生儿心律失常发病率占3年住院新生儿总人数的3.2%。其中窦性心动过缓14例,占60.87%,其病因与围生期窒息、缺氧有关;其次为传导阻滞6例,占26.08%。重度窒息、先心病、药物中毒性心肌炎可出现严重心律失常。结论：围生期窒息、缺氧易引起新生儿出现窦性心动过缓,且新生儿心律失常临床表现不典型,多为暂时性、预后好,大多数不需特殊治疗,但对于感染、药物因素引起的心律失常,应选用抗心律失常药物进行积极治疗。     

新生儿心律失常49例临床分析

新生儿心脏传导系统尚未发育成熟,生理功能不够完善,心律失常并不见。现将1993年5月～1998年12月在我院出生的新生儿发生心律失常49例的临床特点分析如下:资料与结果一、一般资料　本组49例,男30例,女19例。足月儿37例,早产儿9例,过期产儿3例。发病日期:≤1天者26例,2～7天者19例,>7天者4例。同期出生新生儿24973人,发病率1.96‰。胎儿期发生心律失常者18例。临床表现与病因、心律失常类型及程度有关,可无临床症状,或表现为气促、拒奶、哭声弱、面色苍白、阵发性青紫、抽搐等,心脏听诊闻及心率过快、过慢、节律不齐或强弱不一。二、病因及诊…     

新生儿重症监护病房医院感染89例

为探讨新生儿重症监护病房(NICU)医院感染相关因素,现将我院医院感染的新生儿89例进行临床分析,现报道如下。 临床资料 我院NICU1997年11月～2002年4月收治危重新生儿723例,男426例,女297例;胎龄27～42周,日龄1～22d。采用回顾性调查,根据病历资料和医院感染登记表记录的有     

新生儿心律失常15例临床分析

新生儿心律失常有其自身特点，在临床上并不少见，越来越引起新生儿医师的重视。现将我科2005年12月至2006年12月收治的新生儿心律失常15例临床特点分析如下。     

先锋铋治疗新生儿金黄色葡萄球菌肠炎

我科自1985年11月～1986年11月共收治新生儿腹泻68例,其中金黄色葡萄球菌引起重症肠炎42例,占新生儿腹泻61%。现报告如下:     

新生儿非良性快速型心律失常临床特点与疗效观察

目的：探讨新生儿非良性快速型心律失常的临床特点与疗效观察。方法回顾性分析2007年至2014年我院NICU住院的非良性快速型心律失常患儿的临床资料。观察比较新生儿非良性快速型心律失常的发生特点,药物及直流电复律等方法的治疗效果、并发症等。结果非良性快速型心律失常新生儿共13例,其中男10例,女3例;足月儿8例,早产儿4例,过期产儿1例;室性心动过速8例,室上性心动过速5例;原发疾病：重度窒息、败血症、肺炎、上呼吸道感染、心肌炎、呼吸窘迫综合征及先天性心脏病等。其中9例(69.2％)由其他心律失常用药后转化而来。所有病例均使用了抗心律失常药物,10例(76.9％)联合使用了直流电复律治疗。13例中12例治疗有效(92.3％)。复律后短期复发或并发其他严重心律失常8例(61.5％),均使用了乙胺碘伏酮,其中4例治愈。室性心动过速患儿均有严重原发病及诱因,病死率50％(4/8);室上性心动过速患儿无一例死亡。结论非良性快速型心律失常可发生在新生儿各年龄段及各胎龄,其中室上性心动过速预后较好,室性心动过速预后差;运用直流电复律加抗心律失常药是治疗新生儿快速型心律失常的有效方法,抗心律失常药乙胺碘伏酮可能是较好的一种药物选择。     

新生儿心律失常42例

目的：了解新生儿心律失常的病因、临床特点及治疗方法。方法：新生儿心律失常42例病因为感染18例，缺氧11例，先天性心脏病4例，原因不明6例；心律失常表现为室上性心律失常23例，传导异常11例，室性心律心常7例，窦性心动过缓1例；临床主要表现为气促、烦燥不安、面色苍白、阵发性发绀、拒奶及呕吐等非特异性症状。均予营养心肌药物，室上性心动过速者予普罗帕酮，阵发性室性心动过速予利多卡因，预激综合征予普荼洛尔。结果：出院后随访3个月，37例心电图恢复正常，40例存活，2例死亡。结论：新生儿心律失常病因以感染及缺氧为主；临床以快速性心律失常多见，表现无特异性；预后良好。     

新生儿心律失常的诊断及病因探讨

新生儿心律失常不少见 ,国内外均有不少报道 ,近年来由于心电监护和 2 4ｈ动态心电图 (Ｈｏｌｅｅｒ)的应用 ,新生儿心律失常的发现率明显增加 ,有人报道可达 13% [1] 。现将我院 5年以来出生的新生儿发生心律失常 4 8例的诊断及病因探讨如下。1　临床资料1 1　一般资料本组 4 8例均为住院新生儿 ,男 2 9例 ,女 19例。足月儿 32例、早产儿 16例 (其中双胞胎三对 ) ,发病日龄 :≤ 1ｄ者 18例、2～ 7ｄ者 2 3例、>7ｄ者 7例。临床症状及表现与心律失常类型及程度有关 ,可无临床症状 ,或表现为气促、拒奶、哭声弱、面色苍白 ,阵发性紫绀、抽搐…     

Resurgence of measles in Singapore: profile of hospital cases

OBJECTIVE: To ascertain the profile of cases of measles seen at a general hospital during a recent outbreak that occurred despite a measles vaccination program. METHODOLOGY: A retrospective study from January 1991 to March 1998. All patients with measles (ICD code 055. 9) seen at the emergency unit or as inpatients were included. RESULTS: There were 87 cases identified. The diagnosis was clinical in all and proven serologically in 71%. Eighty-five per cent of the cases occurred between January 1997 and March 1998. There was a bi-modal age distribution with peaks in the very young (相似文献   

Allergic factors associated with the development of asthma and the influence of cetirizine in a double-blind, randomised, placebo-controlled trial: First results of ETA®

There is a common progression known as the allergic march from atopic dermatitis to allergic asthma. Cetirizine has several antiallergic properties that suggest a potential effect on the development of airway inflammation and asthma in infants with atopic dermatitis. Methods. Over a two year period, 817 infants aged one to two years who suffered from atopic dermatitis and with a history of atopic disease in a parent or sibling were included in the ETAC^® (Early Treatment of the Atopic Child) trial, a multi-country, double-blind, randomised, placebo-controlled trial. The infants were treated for 18 months with either cetirizine (0.25mg/ kg b.i.d.) or placebo. The number of infants who developed asthma was compared between the two groups. Clinical and biological assessments including analysis of total and specific IgE antibodies were performed. Results. In the placebo group, the relative risk (RR) for developing asthma was elevated in patients with a raised level of total IgE (≥ 30 kU/I) or specific IgE (≥ 0.35 kUA/I) for grass pollen, house dust mite or cat dander (RR between 1.4 and 1.7). Compared to placebo, cetirizine significantly reduced the incidence of asthma for patients sensitised to grass pollen (RR = 0.5) or to house dust mite (RR = 0.6). However, in the population that included all infants with normal and elevated total or specific IgE (intention-to-treat - ITT), there was no difference between the numbers of infants developing asthma while receiving cetirizine or placebo. The adverse events profile was similar in the two treatment groups. Discussion. Raised total IgE level and raised specific IgE levels to grass pollen, house dust mite or cat dander were predictive of subsequent asthma. Cetirizine halved the number of patients developing asthma in the subgroups sensitised to grass pollen or house dust mite (i.e. 20% of the study population). In view of the proven safety of the drug, we propose this treatment as a primary pharmacological intervention strategy to prevent the development of asthma in specifically sensitised infants with atopic dermatitis.     

A profile of respiratory symptoms in urban and rural South Australian school children

This report describes the cross-sectional analyses of data from the first year of a longitudinal study using questionnaire and respiratory function data over a 5 year period from a sample of rural South Australian school children. The cumulative or lifetime prevalences of respiratory symptoms were estimated in 825 rural and 1261 urban school children aged between 5 and 15 years in order to determine if the prevalence rates differed between rural and urban school children. The study found the overall cumulative prevalence of asthma and/or wheezy breathing (AWB) to be 24.1% in the rural school children compared to 27.6% in the urban school children. Most children developed AWB symptoms before the age of 7 years, with 20% reporting moderately severe symptoms and 10% having more than one attack per fortnight. The cumulative prevalence of bronchitis, loose/rattly cough (BLRC) differed significantly between the rural school children (34.1%) and urban school children (47.9%). The BLRC symptoms preceded the development of AWB in many cases. Urban school children also reported a higher prevalence of atopic conditions.     

Hauttemperaturen verschiedener Körperoberflächenareale des Rumpfes bei Säuglingen

Summary In two groups of infants (3–53 weeks old) skin temperatures were controlled in different areas of the trunk—i.e.: regions of sternum, lungs, heart, liver, spleen, kidneys—at different room-temperatures (group I: 21–25°C; group II: 29–32°C). Rectal temperatures of some probands in both groups also had been controlled simultaneously. A definite change in the reaction to heat was proofed in different periods of the first year of life. In higher environmental temperatures the skin temperature was almost constant at every controll-point of the skin, even in older infants. In lower environmental temperatures the skin temperatures lowered continuously with age till 7. to 9. moth. From 10. to 12. month the lowering of skin temperature discontinued. The rectal temperatures were relatively constant in all infants. Only in infants from 7. to 12. month, whose skin temperatures were controlled in lower as well as in higher environmental temperatures, a tendency to higher rectal temperatures was proofed in warmer environmental temperatures.The significance of these results is discussed.

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Untersuchungen mit Unterstützung durch die Deutsche Forschungsgemeinschaft.     

Psychopathologie du syndrome d’Asperger et « aspérigisation » de la société contemporaine

The author has attempted here to point out, just for a start, the characteristics of Asperger syndrome from the point of view of psychopathology through a rereading of Hans Asperger's original paper (1944). This thesis merits reevaluation, if for no other reason than to fill the gaps in operational diagnostics based on the DSM. It is found by rereading that Asperger's view of the principal disturbances of autistic psychopathy include a “disturbance of natural evidence” or a “crisis of common sense”. This question of natural evidence that he evokes with regard to autistic psychopathy corresponds to W. Blankenburg's natural evidence, which constitutes a key concept for comprehending schizophrenia in the form poor-symptom (“symptomarme Schizophrenie”) that he observes in the speech of his patient Anne Rau. One can deduce from this that in terms of fundamental disturbances, Asperger syndrome and this “symptom-poor” schizophrenia overlap at the level of loss of natural evidence. It is moreover possible to classify Asperger syndrome among the disturbances of spacing in the sense meant by the evolutionary psychiatry of A. Stevens and J. Price. The author then develops our comprehension of Asperger syndrome from the point of view of the perspective proposed by the notion of resilience in people with Asperger syndrome and of the possibility for them, through these mechanisms of adaptation, to find in the organization of the personality of the “as if” type a position of relative equilibrium. They concur or overlap in the creation of crutches, of borrowed personalities secondarily legitimated by the reaction of the socius. This will end up in the production of inventions and œuvres (works). Clearly, one rarely encounters several cases that one could consider pertinently to be “successful” Asperger syndrome. Finally, the author notes that one can find a sort of isomorphism between Asperger syndrome and contemporary society when he proposes the term “asperigisation” to characterize our society, given that the equilibrium between emotion and logic is strongly disturbed in these patients, in whom logic undergoes hypertrophy while emotion is impoverished. From this perspective, the author hopes to suggest reasons for the increase in the number of cases of Asperger syndrome in the clinical setting and in society in general in our contemporary era.     

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孤独症谱系障碍(autistic-spectrum disorders,ASDs)近年来患病率逐年攀升至1%左右,其症状往往伴随终生,成为严重威胁儿童健康和发展的神经发育性疾患;注意缺陷多动障碍(attention deficit hyperactivity disorder,ADHD)是儿童期最常见的精神障碍,国内报道患病率为4.13%～5.83%,其症状可延续至青少年期,甚至到成年期[1]。这两类精神障碍在成年期的临床表现、共患病、治疗策略和预后与儿童期有哪些不同呢?本文通过回顾相     

Infiltrations of Epstein-Barr virus-carrying cells in granular lymphocyte-proliferative disorders corresponding to chronic active Epstein-Barr virus infection

A 21-year-old man with granular lymphocyte-proliferative disorders (GLPD) associated with chronic active Epstein-Barr virus (EBV) infection is described. Chromosomal analyses revealed several clonal abnormalities and two of them were mainly repetitious. High copy numbers of monoclonal EBV genome were also detected in the proliferative large granular lymphocytes (LGLs), indicating the monoclonal expansion of EBV-infected LGLs. The patient had an indolent course for several years, and there was no evidence of infiltrations of his bone marrow until the end stage. At autopsy, microscopic studies revealed marked infiltrations of LGL in the liver and spleen, and the infiltrating cells were NK-cell immunophenotype. The infiltrated LGLs showed latency I.     

LUTEINIZING HORMONE RECEPTOR MUTATIONS IN DISORDERS OF SEXUAL DEVELOPMENT AND CANCER

Human male sexual development is regulated by chorionic gonadotropin (CG) and luteinizing hormone (LH). Aberrant sexual development caused by both activating and inactivating mutations of the human luteinizing hormone receptor (LHR) have been described. All known activating mutations of the LHR are missense mutations caused by single base substitution. The most common activating mutation is the replacement of Asp-578 by Gly due to the substitution of A by G at nucleotide position 1733. All activating mutations are present in exon 11 which encodes the transmembrane domain of the receptor. Constitutive activity of the LHR causes LH releasing hormone-independent precocious puberty in boys and the autosomal dominant disorder familial male-limited precocious puberty (FMPP). Both germline and somatic activating mutations of the LHR have been found in patients with testicular tumors. Activating mutations have no effect on females. The molecular genetics of the inactivating mutations of the LHR are more variable and include single base substitution, partial gene deletion, and insertion. These mutations are not localized and are present in both the extracellular and transmembrane domain of the receptor. Inactivation of the LHR gives rise to the autosomal recessive disorder Leydig cell hypoplasia (LCH) and male hypogonadism or male pseudohermaphroditism. Severity of the clinical phenotype in LCH patients correlates with the amount of residual activity of the mutated receptor. Females are less affected by inactivating mutation of the LHR. Symptoms caused by homozygous inactivating mutation of the LHR include polycystic ovaries and primary amenorrhea.     

EXCITING NEW TREATMENT APPROACHES FOR PATHYPHYSIOLOGIC MECHANISMS OF SICKLE CELL DISEASE

During the past several decades, our understanding of the complex pathophysiology of vasoocclusion associated with sickle cell disease has improved greatly. Interaction of genes, hemoglobin molecules, red cell membrane and metabolic changes, cell-cell interactions and cell-plasma interactions, red cell adhesion to vascular endothelium, activation of coagulation, and vascular reactivity play a role in vaso occlusion. Penicillin prophylaxis of pneumococcal infections and appropriate use of blood transfusions and other supportive measures improved survival of sickle cell patients. Hydroxyurea made a major impact on sickle cell therapy when it was shown to decrease acute painful episodes, acute chest syndrome, and the need for blood transfusion in adults. Significant experience in the use of hydroxyurea has been accumulated in older children. The benefits and risks of hydroxyurea for younger children and long-term risks in all patients will be evaluated in future investigations. Other promising therapies include butyrate compounds, clotrimazole, magnesium supplementation, poloxamer 188, antiadhesion agents, anticoagulant approaches, and nitric oxide. Hemopoietic transplantation remains the only curative therapy. However, several transgenic mouse models are available for studies of gene therapy or other treatment approaches on biochemical, cellular, and pathologic effects of mutant genes.