新生儿窒息程度与糖代谢紊乱的关系  

Relationship between neonatal asphyxia and blood glucose disorder

作　　者：周茜茜[1] 胡长霞[1] 殷大欢 夏世文[1] 

机构地区：[1]湖北省妇幼保健院新生儿科,武汉430070

出　　处：《中华围产医学杂志》2016年第5期336-339,共4页Chinese Journal of Perinatal Medicine

摘　　要：目的：探讨新生儿窒息程度与糖代谢紊乱的关系。方法选择2013年1月至2015年1月湖北省妇幼保健院出生且诊断新生儿窒息的患儿134例，检测患儿生后30 min内未输注葡萄糖溶液时的血糖。回顾病历资料，按生后5 min Apgar评分将患儿分为轻度窒息组（4~7分）112例和重度窒息组（0~3分）22例。采用两独立样本t检验及χ2检验比较2组患儿围产期资料及血糖水平。结果窒息患儿占同期本院活产儿的3.2‰（134/41875）。轻度窒息组血糖紊乱以低血糖为主[12%（13/112）]，重度窒息组血糖紊乱以高血糖为主[32%（7/22）]。重度窒息组平均血糖水平高于轻度窒息组[（5.8±3.4）与（5.0±2.3）mmol/L，t=21.979，P=0.001]。重度窒息组低血糖发生率高于轻度窒息组[18%（4/22）与12%（13/112），χ2=7.464，P=0.006]，且平均血糖值更低[（1.8±0.7）与（2.1±0.4）mmol/L，t=5.247，P=0.042]；重度窒息组高血糖发生率明显高于轻度窒息组[32%（7/22）与9%（10/112），χ2=11.679，P=0.001]，且平均血糖值更高[（11.6±3.8）与（9.3±2.0）mmol/L，t=1.106，P=0.048]。结论新生儿窒息可导致糖代谢紊乱；窒息程度越重，血糖紊乱发生率越高，程度越重。Objective To study the association between neonatal asphyxia and blood glucose disorder. Methods A total of 134 cases of neonatal asphyxia born in the Maternal and Child Hospital of Hubei Province between January 2013 and January 2015 were included in this study. Blood glucose levels were determined within 30 min after birth and before glucose infusion. The infants were divided into the mild asphyxia group （Apgar score 4 to 7） and severe asphyxia group （Apgar score 0 to 3） according to the Apgar score at 5 min after birth. Statistical analyses were performed using the two-sample t-test and Chi-square test. Results The incidence of asphyxia was 3.2‰（134/41 875）. Hypoglycemia was the main blood glucose disorder in the mild asphyxia group [12% （13/112）], and hyperglycemia was the main blood glucose disorder in the severe asphyxia group [32%（7/22）]. The average blood glucose level was higher in the severe asphyxia group than in the mild asphyxia group [（5.8±3.4） vs （5.0±2.3） mmol/L, t=21.979, P=0.001]. In the severe asphyxia group, the incidence of hypoglycemia was higher [18% （4/22） vs 12% （13/112）, χ2=7.464, P=0.006] and the average blood glucose level was lower [（1.8±0.7） vs （2.1±0.4） mmol/L, t=5.247, P=0.042],and the incidence of hyperglycemia was also higher [32% （7/22） vs 9% （10/112）, χ2=11.679, P=0.001] and the blood glucose level was higher [（11.6±3.8） vs （9.3±2.0） mmol/L, t=1.106, P=0.048]. Conclusion Neonatal asphyxia can lead to blood glucose disorders. The incidence and the severity of these disorders were higher in neonates with severe asphyxia.

关 键 词：新生儿窒息 葡萄糖代谢障碍 血糖 

分 类 号：R722.1[医药卫生—儿科]