早产儿血糖紊乱与C肽、胰岛素和皮质醇的关系

Relationship of blood glucose disorder with C-peptide, insulin, and cortisol concentrations

目的探讨早产儿血糖紊乱的特点及影响血糖变化的高危因素。方法对70例早产儿和50例足月儿进行血糖及C肽、胰岛素和皮质醇监测。结果早产儿和足月儿发生血糖紊乱的比例分别为44．3％和6．o％；孕34-37周早产儿出生后24h血糖水平高于其它两组早产儿，但低于足月新生儿；孕32周-、34-37剧早产儿出生后24h皮质醇水平低于足月新生儿组，孕周〈32周早产儿出生后24h及出生后3d皮质醇水平高于足月新生儿组，差异均有统计学意义。早产儿与足月儿C肽、胰岛素水平比较，差异无统计学意义。结论早产儿血糖紊乱发生率高，早期皮质醇水平可能是影响血糖变化的高危因素，加强早产儿血糖监测可有效防治早产儿血糖紊乱及其带来的不良后果。

Objective To characterize blood glucose disorders and factors associated with blood glucose changes in premature infants. Methods Blood glucose and C-peptide, insulin, and cortisol concentrations in 70 premature infants were measured and compared with 50 term infants. Results Blood glucose disorders were observed in 44.3 % of pre- term infants and in 6.0 % of term infants, with the former rate statistically higher and the latter. Blood glucose concentra- tions were significantly higher in 34-37 week premature infants than those of the other two premature infant groups, but were significantly lower than those of term infants. Cortisol concentrations at 24 hour after birth were significantly lower in 32 weeks and 34-37 weeks premature infants than those of term infants. However, cortisol concentrations at 24 hour and the 3rd day after birth were significantly higher in less than 32 week premature infants than those of term infants. There were no significantly differences between premature infants and term infants in C-peptide and insulin concentrations. Conclu- sion Premature infants are more likely to have blood glucose disorders and cortisol is associated with blood glucose in pre- mature infants. Blood glucose monitoring may help prevent blood glucose disorders and their sequelae.