CAJ | 학술논문

目的：观察新生儿低血糖与脑损伤发生的关系，为临床低血糖性脑损伤的防治提供理论依据。方法回顾性分析2009年1月~2010年12月在广西壮族自治区妇幼保健院新生儿科住院的90例新生低血糖患儿的临床资料，按有无脑损伤分为脑损伤组及无脑损伤组，分别为39例和51例。比较早产儿与足月儿、母、婴围生因素及临床表现在两组间的差异。结果早产儿低血糖发生率为83.3%，显著高于足月儿的16.7%，差异有高度统计学意义(P<0.01)；低血糖性脑损伤发生率为43.33%；母亲妊娠期糖尿病婴儿低血糖性脑损伤发病率显著高于母亲无妊娠期糖尿病婴儿，差异有高度统计学意义(P<0.01)。脑损伤组在胎龄、5 min及10 min Apgar评分均显著低于无脑损伤组，差异有高度统计学意义(P<0.01)；有症状的低血糖患儿脑损伤显著高于无症状者，差异有高度统计学意义(P<0.01)。脑损伤组血糖最低值显著低于无脑损伤组，差异有高度统计学意义(P<0.01)；低血糖持续时间显著长于无脑损伤组，差异有高度统计学意义(P<0.01)。结论早产儿易发生低血糖；母亲妊娠期糖尿病、胎龄小、出生5 min及10 min Apgar评分、血糖最低值、低血糖持续时间与脑损伤发生率密切相关。
목적：관찰신생인저혈당여뇌손상발생적관계，위림상저혈당성뇌손상적방치제공이론의거。방법회고성분석2009년1월~2010년12월재엄서장족자치구부유보건원신생인과주원적90례신생저혈당환인적림상자료，안유무뇌손상분위뇌손상조급무뇌손상조，분별위39례화51례。비교조산인여족월인、모、영위생인소급림상표현재량조간적차이。결과조산인저혈당발생솔위83.3%，현저고우족월인적16.7%，차이유고도통계학의의(P<0.01)；저혈당성뇌손상발생솔위43.33%；모친임신기당뇨병영인저혈당성뇌손상발병솔현저고우모친무임신기당뇨병영인，차이유고도통계학의의(P<0.01)。뇌손상조재태령、5 min급10 min Apgar평분균현저저우무뇌손상조，차이유고도통계학의의(P<0.01)；유증상적저혈당환인뇌손상현저고우무증상자，차이유고도통계학의의(P<0.01)。뇌손상조혈당최저치현저저우무뇌손상조，차이유고도통계학의의(P<0.01)；저혈당지속시간현저장우무뇌손상조，차이유고도통계학의의(P<0.01)。결론조산인역발생저혈당；모친임신기당뇨병、태령소、출생5 min급10 min Apgar평분、혈당최저치、저혈당지속시간여뇌손상발생솔밀절상관。
Objective To investigate the relationship between neonatal hypoglycemia and brain injury, so as to provide a theoretical basis for clinical treatment of hypoglycemic brain injury. Methods From January 2009 to December 2010, 90 cases of children with neonatal hypoglycemia were admitted to the retrospective analysis in neonatal department of Maternal and Child Health Hospital of Guangxi Zhuang Autonomous Region. They were divided into brain injury group and non-brain injury group according to the presence of brain injury, 39 cases and 51 cases respectively, the differ-ences of preterm infants and term infants, perinatal factors of mother and baby, clinical manifestation between the two groups were compared. Results The incidence of hypoglycemia in premature infants was 83.3%, significantly higher than that of term infants (16.7%), the differences were statistically significant (P<0.01);the incidence of hypoglycemic brain injury was 43.33%. The incidence of hypoglycemic brain injury in infants whose mother had gestational diabetes was significantly higher than that of mother without gestational diabetes, the differences were statistically significant (P< 0.01). Gestational age, 5 min and 10 min Apgar scores in brain injury group were significantly lower than the non-brain injury group, the differences were statistically significant (P< 0.01). Brain injury in children with symptomatic hypoglycemia was significantly higher than that in asymptomatic children, the difference was statistically significant (P< 0.01), the lowest value of blood glucose in brain injury group was significantly lower than that in non-brain injury group, the difference was statistically significant (P< 0.01), and the duration of hypoglycemia was significantly longer than the non- brain injury group, the difference was statistically significant (P< 0.01). Conclusion Premature infants are prone to hypoglycemia, and the incidence of brain injury are closely related with mothers with gestational diabetes, small gestational age, 5 min and 10 min Apgar scores, the lowest value of blood glucose, the duration of hypoglycemia.