缺血缺氧性脑病新生儿血清皮质醇、乳酸和血糖水平变化及临床意义

Changes and clinical significance of blood sugar,serum cortisol and lactic acid in neonates with hypoxic-ischemic encephalopathy

目的探讨缺氧缺血性脑病(HIE)新生儿血清皮质醇(COR)、乳酸(LA)和葡萄糖(GLU)水平的变化及其临床意义。方法对86例HIE新生儿和50例对照组进行血清GLU、COR和LA检测并分析。结果 HIE患儿除轻度组外,血清GLU水平均显著高于对照组(P<0.05);HIE患儿COR和LA水平均明显高于对照组(P<0.01),且HIE程度越重,血清GLU、COR和LA水平升高越明显;治疗后,HIE患儿血清COR和LA含量呈下降趋势。结论临床治疗HIE过程中要严密观察GLU、COR和LA的变化,严格控制葡萄糖输注的量及速度,应用糖皮质激素时严格掌握其适应证及剂量,以防止肾上腺皮质萎缩、高血糖及乳酸酸中毒的发生,以减少后遗症和HIE患儿死亡率。

Objective To investigate the changes and clinical significance of glucose （GLU） ,serum conical （COR） and lactic acid in neonate with hypoxic - ischemie encephalopathy （HIE）. Methods A total of 113 neonate with HIE and 50 healthy neonate were enrolled in this study for measurement of serum concentrations of GLU, COR and LA. Results The level of serum GLU in HIE groups except slight was higher than control group （P 〈0.05 ） ;the concentration of serum COR and LA of neonate with HIE was significantly higher than control group （P 〈 0.01 ）. The more severe degree of HIE was, the higher level of GLU, COR and LA increased ; after treat, the concentration of serum COR and LA of 86 neonate with hyperglycemia was drop. Conclusion Clinical treatment during the process of HIE need to close observation of the COR GLU and LA chan- ges, strictly control the amount of glucose infusion and speed. Use of corticoster6ids strictly grasp its indication and dose, pre- vent adrenal cortical atrophy, high blood sugar and lactic acidosis happened,in order to reduce sequela and HIE children mor- tality.