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目的探讨早产儿血糖异常与脑损伤发生率的关系。方法对138例早产儿分别于出生0 h、2 h、4 h、8 h、12 h、24 h进行血糖检测,血糖正常者入血糖正常组,血糖异常者分别入高、低血糖组,并于48 h、72 h继续监测血糖变化,血糖正常组若发生血糖波动及时调整组别。观测血糖异常持续时间,依据血糖异常时间分为0～6 h组,>6～<24 h组,≥24 h组。采用足跟血,应用ACCU-CHEK罗氏血糖仪进行血糖测定。出生7 d行颅脑CT或MRI检查。比较血糖正常组及高、低血糖组早产儿脑损伤的发生率。结果血糖正常组脑损伤发生率为5.66%(3/53例),低血糖组脑损伤发生率为20.29%(14/69例),高血糖组脑损伤发生率为37.50%(6/16例)。血糖异常持续时间越长,脑损伤发生率越高,而持续高血糖引起早产儿脑损伤的比率大于低血糖组,但无统计学差异。结论早产儿血糖异常波动是导致早产儿脑损伤的重要原因之一,血糖异常持续时间越长,早产儿脑损伤的发生率越高。
Objective To investigate the relationship between the abnormal blood glucose in preterm infants and the incidence of brain injury. Methods Blood samples were collected from 138 preterm infants at 0 h, 2 h, 4 h, 8 h, 12 h, and 24 h after birth. The subjects with normal blood glucose were divided into normal and hypoglycemic groups At 48 h, 72 h continue to monitor changes in blood glucose, glycemic control group in case of fluctuations in blood glucose promptly adjusted group. The duration of abnormal blood glucose was observed and divided into 0 ~ 6 h group,> 6 ~ <24 h group, and> 24 h group according to the time of abnormal blood glucose. Using heel blood, blood glucose was measured using the ACCU-CHEK Roche Blood Glucose Meter. 7 days after birth, brain CT or MRI examination. Compare the incidence of brain injury in the normal group and high and low blood sugar group. Results The incidence of brain injury was 5.66% (3/53 cases) in normal blood glucose group, 20.29% (14/69 cases) in hypoglycemia group and 37.50% (6/16 cases) in hyperglycemia group ). The longer the duration of abnormal blood glucose, the higher the incidence of brain injury, while the rate of brain damage caused by persistent hyperglycemia in preterm infants was higher than that of hypoglycemia group, but no statistical difference was found. Conclusion The abnormal blood glucose in premature infants is one of the important causes of brain injury in premature infants. The longer the abnormal blood glucose, the higher the incidence of brain injury in premature infants.