婴幼儿病毒性脑炎并发神经源性肺水肿血糖及电解质检测的意义  

Clinical significance of detetcting blood sugar and serum electrolytes in infants with viral encephalitis complicated with neurogenic pulmonary edema

作　　者：沈怀云[1] 陈贞祥[1] 周瑞[1] 诸宏伟[1] 丁周志[1] 张帆[1] 

机构地区：[1]蚌埠医学院第一附属医院儿科,安徽蚌埠233004

出　　处：《中国微生态学杂志》2011年第4期344-345,348,共3页Chinese Journal of Microecology

摘　　要：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 relationship between the variation in blood sugar and serum electrolytes and development of the disease in infants with viral encephalitis complicated with neurogenic pulmonary edema（NPE）.Method 19 infants with viral encephalitis in our hospital from June 2008 to November 2010 were selected and divided into two groups based on their accompanied disease： infants with NPE（n=9,NPE group） and infants without NPE（n=10,non NPE group）.The first venous blood samples of the infants from these two groups were drawn for analysis of blood sugar and serum electrolytes,which were calculated by student′s-t test and Fisher exact probabilities in 2×2 table.Result The blood sugar levels of infants in the NPE group [（19.24±9.64）mmol/L] were significantly higher than those in non NPE group [（4.90±1.11）mmol/L]（t=4.44,P0.01）,but the serum calcium levels of infants in the NPE group [（1.75±0.32）mmol/L] were significantly lower than those in non NPE group [（2.37±0.17）mmol/L]（t=-5.31,P0.01）.The incidences of high blood sugar and hypocalcemia in the NPE group were far greater than in non NPE group（P0.01）.There were no significant differences in the serum potassium,sodium and chlorine levels between the two groups（P0.05）.Conclusion Viral encephalitis of infants complicated with NPE may give rise to the change of blood sugar and serum electrolyte disturbance.Hyperglycemia and hypocalcemia are the risk factors which lead to NPE.Early detection of blood sugar and calcium levels can be used as effective indexes judging condition and prognosis of infants with viral encephalitis complicated with NPE.

关 键 词：婴幼儿 病毒性脑炎 神经源性肺水肿 血糖 血清电解质 

分 类 号：R512.3[医药卫生—内科学]