超早产儿早期高血糖症发生情况及危险因素分析  

The incidence and risk factors of early hyperglycemia in extremely preterm infants

作　　者：孙小凡 辜楠[1] 韩树萍[1] 陈小慧[1] 吴琦[1] 程佳[1] Sun Xiaofan;Gu Nan;Han Shuping;Chen Xiaohui;Wu Qi;Cheng Jia(Department of Pediatrics,Nanjing Maternity and Child Health Care Hospital,Women's Hospital of Nanjing Medical University,Nanjing 210004,China)

机构地区：[1]南京市妇幼保健院,南京医科大学附属妇产医院儿科,南京210004

出　　处：《中华新生儿科杂志（中英文）》2023年第1期18-22,共5页Chinese Journal of Neonatology

基　　金：南京市医学科技发展基金(ZKX19045)。

摘　　要：目的分析超早产儿(extremely preterm infants,EPI)早期高血糖症的发生情况及危险因素。方法选择2018年1月至2021年12月南京市妇幼保健院出生并收治于新生儿科的胎龄<28周超早产儿进行回顾性研究,根据是否发生早期高血糖症(生后1周内)分为高血糖组和非高血糖组,采用单因素及Logistic回归分析超早产儿发生早期高血糖症的危险因素。结果共纳入218例超早产儿,高血糖组70例(32.1%),非高血糖组148例(67.9%)。胎龄<25周超早产儿早期高血糖症发生率为10/20,出生体重≤700 g超早产儿早期高血糖症发生率为11/16。高血糖组胎龄及出生体重低于非高血糖组,1 min及5 min Apgar≤7分比例高于非高血糖组,差异均有统计学意义(P<0.05)。Logistic回归分析显示,出生体重增加(OR=0.995,95%CI 0.993~0.997,P<0.05)是超早产儿早期高血糖症的保护因素,男婴(OR=2.512,95%CI 1.232~5.123,P<0.05)、生后1周内使用血管活性药物(OR=2.687,95%CI 1.126~6.414,P<0.05)、母亲妊娠期高血压(OR=14.735,95%CI 1.578~137.585,P<0.05)是超早产儿发生早期高血糖症的危险因素。结论超早产儿早期高血糖症的发生率高,出生体重低、男婴、生后第1周内使用血管活性药物、母亲妊娠期高血压可增加早期高血糖症风险。Objective To study the incidence and risk factors of early hyperglycemia in extremely preterm infants(EPIs).Methods From January 2018 to December 2021,EPIs with gestational age(GA)<28 w born in our hospital and admitted to the neonatal department were retrospectively studied.According to the occurrence of early hyperglycemia(within 1 w after birth),the infants were assigned into hyperglycemia group and non-hyperglycemia group.Univariate and logistic regression were used to analyze the risk factors of early hyperglycemia in EPIs.Results A total of 218 cases of EPIs were enrolled,including 70(32.1%)in the hyperglycemia group and 148(67.9%)in the non-hyperglycemia group.The incidence of early hyperglycemia in EPIs with GA<25 w was 10/20 and 11/16 in EPIs with birth weight(BW)≤700 g.The GA and BW of the hyperglycemia group were significantly lower than the non-hyperglycemia group(P<0.05).More infants in the hyperglycemia group had 1-min and 5-min Apgar≤7 than the non-hyperglycemia group(P<0.05).Logistic regression analysis showed that increased BW(OR=0.995,95%CI 0.993~0.997,P<0.05)was a protective factor for early hyperglycemia in EPIs,while male gender(OR=2.512,95%CI 1.232~5.123,P<0.05),vasoactive drug use during the first week of life(OR=2.687,95%CI 1.126~6.414,P<0.05),maternal hypertension during pregnancy(OR=14.735,95%CI 1.578~137.585,P<0.05)were risk factors for early hyperglycaemia in EPIs.Conclusions Early hyperglycemia are common among EPIs.Low BW,male gender,vasoactive drug use during the first week of life and maternal hypertension during pregnancy may increase the risk of early hyperglycemia.

关 键 词：超早产儿 超低出生体重儿 高血糖症 危险因素 

分 类 号：R722.6[医药卫生—儿科]