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早产儿血糖紊乱的特点及相关危险因素分析

赵武 ,  夏群 ,  徐家新

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文章导航 > 蚌埠医学院学报  > 2012,  36 > 8: (913-917)  
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早产儿血糖紊乱的特点及相关危险因素分析

  • 1.

    蚌埠医学院第一附属医院儿科, 安徽, 蚌埠, 233004

    • 作者简介: 赵武(1970-),医师，副教授.男，博士，硕士研究生导师，副主任
  • 基金项目:

Characteristics of dysglycemia in preterm infants and related risk factors

  • 1.

    Department of Pediatrics, The First Affiliated Hospital of Bengbu Medical College, Bengbu Anhui 233004, China

  • 摘要: 目的：探讨早产儿血糖紊乱的特点、调控方法和相关危险因素。方法：将日龄3 d以内的84例早产儿按体重分为1 500 g组(30例)和1 500 g组(54例)。2组早产儿入院后即刻用血糖仪测定全血血糖，然后给予葡萄糖静脉输注，速度设定为6 mg.kg-1.min-1，根据全血血糖监测情况及时调整葡萄糖输液速度，必要时给予胰岛素治疗，分析早产儿血糖紊乱的特点和相关危险因素。结果：入院初始发生低血糖11例(13.1%)，其中体重1 500 g组低血糖发生率为26.7%，明显高于体重1 500 g组的5.6%(P0.05)。输糖后发生高血糖41例(48.8%)，其中体重1 500 g组高血糖发生率为73.3%，明显高于体重1 500 g组的35.2%(P0.01)。41例高血糖中除2例持续性高血糖使用胰岛素治疗外，余39例均通过减慢葡萄糖输液速度得到控制。多因素Logistic回归分析显示体重1 500 g(P0.05)、窒息(P0.01)、缺氧性脑损伤(P0.01)和颅内出血(P0.05)为早产儿高血糖独立危险因素。结论：早产儿尤其是极低出生体重儿出生后第1周易发生血糖紊乱，高血糖较低血糖更加常见。多数早产儿高血糖通过减慢葡萄糖输液速度可以得到控制。体重1 500 g、窒息、缺氧性脑损伤、颅内出血是早产儿高血糖的独立危险因素。
    Abstract: Objective:To explore the characteristics and regulation of dysglycemia in preterm infants,and related risk factors.Methods:Eighty-four preterm infants within 3 days of life were divided into two groups:one group weighing less than 1 500 g(30 cases) and the other weighing more than or equal to 1 500 g(54 cases).After admission,the whole blood glucose levels of all preterm infants were immediately measured using glucometer.Intravenous glucose infusion was then given at a rate of 6 mgkg-1min-1,and the glucose infusion rate was subsequently adjusted on the basis of measured glucose levels to maintain euglycemia.Insulin therapy was administered when necessary.The characteristics of dysglycemia in preterm infants and related risk factors were analysed.Results:Hypoglycemia occurred in 11 infants(13.1%) after admission.The hypoglycemia incidence was significantly higher in 1 500 g group than in 1 500 g group(26.7% vs 5.6%,P0.05).Hyperglycemia occurred in 41 infants(48.8%) after infusion of glucose.The hyperglycemia incidence was considerably higher in 1 500 g group than in 1 500 g group(73.3% vs 35.2%,P0.01).The hyperglycemia in 39 of the 41 preterm infants was controlled by gradually decreasing the glucose infusion rate.Persistent hyperglycemia(14 mmol/L) in the remaining two preterm infants was controlled by insulin treatment.Multivariate logistic regression analysis showed that birth weight less than 1 500 g(P0.05),asphyxia(P0.01),hypoxic brain damage(P0.01),and intracranial hemorrhage(P0.05) were significantly associated with hyperglycemia in preterm infants.Conclusions:Preterm infants are at high risk of dysglycemia during the first week of life,especially for very low birth weight infants,and hyperglycemia is more common than hypoglycemia.For most preterm infants,hyperglycemia can be controlled by reducing the glucose infusion rate.Weight less than 1 500 g,asphyxia,hypoxic brain damage,and intracranial hemorrhage were independent risk factors for preterm infant hyperglycemia.
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  • 收稿日期:  2012-01-16
  • 刊出日期:  2012-08-15

早产儿血糖紊乱的特点及相关危险因素分析

    作者简介: 赵武(1970-),医师，副教授.男，博士，硕士研究生导师，副主任
  • 1. 蚌埠医学院第一附属医院儿科, 安徽, 蚌埠, 233004
  • 收稿日期: 2012-01-16
  • 网络出版日期: 2012-08-15
基金项目: 

摘要: 目的：探讨早产儿血糖紊乱的特点、调控方法和相关危险因素。方法：将日龄3 d以内的84例早产儿按体重分为1 500 g组(30例)和1 500 g组(54例)。2组早产儿入院后即刻用血糖仪测定全血血糖，然后给予葡萄糖静脉输注，速度设定为6 mg.kg-1.min-1，根据全血血糖监测情况及时调整葡萄糖输液速度，必要时给予胰岛素治疗，分析早产儿血糖紊乱的特点和相关危险因素。结果：入院初始发生低血糖11例(13.1%)，其中体重1 500 g组低血糖发生率为26.7%，明显高于体重1 500 g组的5.6%(P0.05)。输糖后发生高血糖41例(48.8%)，其中体重1 500 g组高血糖发生率为73.3%，明显高于体重1 500 g组的35.2%(P0.01)。41例高血糖中除2例持续性高血糖使用胰岛素治疗外，余39例均通过减慢葡萄糖输液速度得到控制。多因素Logistic回归分析显示体重1 500 g(P0.05)、窒息(P0.01)、缺氧性脑损伤(P0.01)和颅内出血(P0.05)为早产儿高血糖独立危险因素。结论：早产儿尤其是极低出生体重儿出生后第1周易发生血糖紊乱，高血糖较低血糖更加常见。多数早产儿高血糖通过减慢葡萄糖输液速度可以得到控制。体重1 500 g、窒息、缺氧性脑损伤、颅内出血是早产儿高血糖的独立危险因素。

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