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目的探讨婴幼儿病毒性脑炎并发神经源性肺水肿(neurogenic pulmonary edema,NPE)血糖、血清电解质的变化及与病情发展的关系。方法选择2008年6月至2010年11月蚌埠医学院第一附属医院收治的婴幼儿病毒性脑炎患儿19例为研究对象,依据患儿是否并发NPE分为2组,NPE组9例,非NPE组10例。以入院后第1次静脉血的血糖和电解质为评价标准,并应用t检验和四格表资料的Fisher确切概率法,进行血糖和血清电解质比较。结果 NPE组患儿血糖水平[(19.24±9.64)mmol/L]显著高于非NPE组[(4.90±1.11)mmol/L](t=4.44,P<0.01),而血钙水平[(1.75±0.32)mmol/L]显著低于非NPE组[(2.37±0.17)mmol/L](t=-5.31,P<0.01)。NPE组高血糖和低钙血症发生率远大于非NPE组(P<0.01)。2组血清钾、钠、氯变化差异无统计学意义(P>0.05)。结论婴幼儿病毒性脑炎并发NPE可引起血糖改变和电解质紊乱。高血糖和低钙血症是导致NPE的危险因素,早期检测血糖及血钙水平可作为判断婴幼儿病毒性脑炎并发NPE病情和预后的有效指标。
Objective To investigate the changes of blood glucose and serum electrolytes in patients with viral encephalitis complicated with neurogenic pulmonary edema (NPE) in infants and young children and its relationship with the progression of the disease. Methods Nineteen infants with viral encephalitis admitted to the First Affiliated Hospital of Bengbu Medical College from June 2008 to November 2010 were divided into two groups according to whether they had NPE or not, and nine patients with NPE. Non-NPE group of 10 cases. Blood glucose and electrolytes in the first venous blood after admission were evaluated, and t-test and Fisher’s exact test were used to compare blood glucose and serum electrolytes. Results The blood glucose level of [(19.24 ± 9.64) mmol / L] in NPE group was significantly higher than that of non-NPE group (4.90 ± 1.11 mmol / L, t = 4.44, ± 0.32) mmol / L] was significantly lower than that of non-NPE group [(2.37 ± 0.17) mmol / L] (t = -5.31, P <0.01). The incidence of hyperglycemia and hypocalcemia in NPE group was much higher than that in non-NPE group (P <0.01). There was no significant difference in serum potassium, sodium and chloride between the two groups (P> 0.05). Conclusion Infantile viral encephalitis complicated with NPE can cause changes in blood glucose and electrolyte imbalance. Hyperglycemia and hypocalcemia are the risk factors leading to NPE. Early detection of blood glucose and serum calcium levels can be used as a good indicator to judge the prognosis and prognosis of NPE in infants with viral encephalitis.