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目的通过回顾性研究低血糖患儿体内支链氨基酸代谢水平变化,探讨串联质谱检测支链氨基酸在低血糖患儿早期诊疗中的的应用价值。方法选取2014年7月~2015年12月我院新生儿病区住院的130例低血糖患儿为研究组,其中低血糖易纠正的暂时性低血糖患儿106例为A组,不易纠正的持续性低血糖患儿24例为B组;同时选择同期正常新生儿100例为对照组,运用串联质谱技术检测分析研究各对象支链氨基酸水平:Leu(亮氨酸)、Ile(异亮氨酸)、Val(缬氨酸),统计分析其代谢水平的变化。结果与对照组比较,研究A组的Leu、Ile、Val水平并无明显差别;研究B组则明显高于对照组,差异具统计学意义(P<0.05)。结论支链氨基酸水平异常是引起患儿低血糖的一种因素,在不易纠正的持续性低血糖的患儿,极有可能是遗传代谢病引起的氨基酸代谢异常,从而引起低血糖症状。在低血糖症状出现前监测支链氨基酸水平变化,对临床早期预防遗传代谢引起的低血糖以及预后的应用价值较高,可为临床在诊疗提供科学依据参考。
Objective To investigate the value of tandem mass spectrometry in the early diagnosis and treatment of hypoglycemia in children with hypoglycemia by retrospectively studying the changes of branched-chain amino acid metabolism in children with hypoglycemia. Methods A total of 130 children with hypoglycemia who were hospitalized in neonatal ward of our hospital from July 2014 to December 2015 were selected as the research group. Among them, 106 children with transient hypoglycemia who were easily corrected by hypoglycemia were group A, which were difficult to correct 24 cases of persistent hypoglycemia in group B; the same time, select the normal newborn 100 cases as the control group, using tandem mass spectrometry to detect and analyze the object of the branched-chain amino acid levels: Leu (leucine), Ile Acid), Val (valine), statistical analysis of its metabolic changes. Results Compared with the control group, there was no significant difference in Leu, Ile, Val between study group A and study group B, but the difference was statistically significant (P <0.05). Conclusions Abnormal branched-chain amino acids are one of the factors that cause hypoglycemia in children. In children with persistent hypoglycemia that is not easy to correct, it is most likely that the metabolism of amino acids is caused by inherited metabolic diseases, causing hypoglycemia. Monitoring the change of BCAA before the onset of hypoglycemia is of high value in the prevention of hypoglycaemia and prognosis caused by the prevention of genetic metabolism in the early stage of clinical practice, which may provide a scientific basis for clinical diagnosis and treatment.