脉搏血氧饱和度检测能提高新生儿心脏缺陷诊断率

脉搏血氧饱和度检测能提高新生儿心脏缺陷诊断率 脉搏血氧饱和度检测能提高新生儿心脏缺 陷诊断率 velopment,1994,120(5):1071—1083. [15]ChobotovaK,SpyropoulouI,CarverJ,eta1.Heparin-bindingepi— dermalgrowthfactoranditsreceptorErbB4mediateimplantationof thehumanblastocyst[J].MechDev,2002,119(2):137-144. [16]MartinKL,Barlow,DH,SargentIL.Heparin-bindingepidermal growthfactorsignificantlyimproveshumanblastocystdevelopment andhatchinginserumfreemedium【j].HumReprod,1998,13 (6):1645-1652. [17]StewartCL,KasparP,BrunetLJ,eta1.Blastocystimplantation dependsonmaternalexpressionofleukaemiainhibitoryfactor[J]. Nature,1992,359(6390):76-79. [18]姜群英,陈士岭.肝素结合性表皮生长因子与生殖[J].国外医 学:妇产科学分册,2000,27(2):88-90. [19]TangB,GurpideE.Directeffectofgonadotropinsondecidualiza- tionofhumanendometrialstromacells『J].SteroidBiochemMol Biol,1993,47(1-6):115—121 [2O]TanY,LiM,CoxS,eta1.HB—EGFdirectsstromalcell polyploidyanddecidualizationviacyclinD3duringimplantation 195. [J].DevBiol,2004,265(1):181— [21]WangJ,MayernikL,SchuhzJF,eta1.Accelerationoftrophoblast differentiationbyheparin—-bindingEGF-?likegrowthfactorisde— pendentonthestagespecificactivationofcalciuminfluxbyErbB receptorsindevelopingmouseblastocysts[J].Development, 2000,127(1):33-44. ? 医学前沿? 山东医药2012年第52卷第6期 [22]Liuz,ArmantDR.Lysophosphatidicacidregulatesmurineblasto- cystdevelopmentbytransactivationofreceptorsforheparin—binding EGFlikegrowthfactor[J].ExpCellRes,2004,296(2):317— 326. [23]LesseyBA,GuiY,ApparaoKB,eta1.Regulatedexpressionof EGF)inthehuman heparin-bindingEGF-likegrowthfactor(HB— endometrium:apotentialparaerineroleduringimplantation[J]. MolReprodDev,2002,62(4):4-46-455. [24]LesseyBA.Adhesionmoleculesandimplantation[J].ReprodIm— munol,2002,55(1-2):101—112. [25]LimJJ,LeeDR,SongHS,eta1.Heparin—bindingepidermal growthfactor(HB?EGF)mayimproveembryonicdevelopmentand implantationbyincreasingvitronectinreceptor(integrinalphanube— ta3)expressioninperi—implantationmouseembryos[J].Assist ReprodGenet,2006,23(3):111—119. [26]LesseyRA,GuiY,ApparaoKB,eta1.Regulatedexpressionof heparin—bindingEGF—likegrowthfactor(HB—EGF)inthehuman endometriumapotentialparacrineroleduringimplantation[J]. MolReprodDev,200,62(4):44-55. [27]Castro—Rend6nWA,Castro—lvarezJF,Guzm6n—MartinezC,eta1. Blastocyst—endometriuminteraction:intertwiningacytokinenet— work[J].BrazJMedBiolRes,2006,39(11):1373-1385. (收稿日期:2011—12-23) 脉搏血氧饱和度检测能提高新生儿心脏缺陷诊断率 2008年2月,2009年1月,伯明翰大学及伯明翰女子医院的AndrewEwer及其同 事们对来自英国 不同地方,6个产科,超过20000名健康的新生儿进行了脉搏血氧饱和度筛查并随访至l2个月大.发 现脉搏血氧饱和度检测能够筛查出75%的危重病例及49%的严重先天性心脏缺陷.排除产前超声怀 疑为先天性心脏缺陷的35例患者,应用脉搏血氧仪危重病例检出率为58%,严重病例为28%.脉搏血 氧饱和度检测与常规超声,新生儿体检相结合应用时,能够将危重型先天性心脏病的检出率提高到 92%,并且没有婴儿死于未明确诊断的心脏病.脉搏血氧饱和度检测筛查危重型先天性心脏病的假阳 }生率为0.8%(169名新生儿),其中有6例有显着的心脏缺陷,另外有4O名婴儿患有其他疾病(呼吸系 统疾病和感染),需要紧急医疗干预.故作者认为脉搏血氧饱和度检测是一项安全的,非侵入性的,可 行且合理的精确检测技术,其灵敏度要优于产前筛查和临床检查. (整理自 EwerAK,MiddletonLJ,FurmstonAT.Pulseoximetryscreeningforcongenitalheartdefectsi n newborninfants(PulseOx):atestaccuracystudy[J].Lancet,2011,378(9793):785—794.) 98