新生儿窒息对糖代谢影响的研究

The Study of the Effect of Perinatal Asphyxia on Glucose Metabolism

目的 :研究围产期窒息对新生儿血糖及其调节激素的影响。方法 :对 40例窒息患儿生后 72h内进行连续血糖监测 ,同时测定血清皮质醇 (CT)、胰岛素 (INS)、胰高血糖素 (GC)和生长激素 (GH)的浓度。结果 :轻度窒息对新生儿糖代谢无影响 ;重度窒息生后 6h血糖最高 ,36h最低 (P <0 .0 1) ,4种激素水平均明显增高 (P <0 .0 1) ,多元线性回归分析发现重度窒息后 6～ 12h血糖值与CT和GC水平呈显著性正相关 (P <0 .0 1) ,证实了新生儿重度窒息后高胰岛素血症和高血糖并存现象。结论 :应激反应在新生儿重度窒息后高血糖的发生中起重要作用 ,血糖监测对重度窒息患儿十分重要 。

Objective To study the effect of perinatal asphyxia on glucose metabolism and its regulating hormones neonate.Methods We made a continuous micromonitor of blood sugar level of asphyxiated newborns during the first 3 days of their life and assayed their serum concentration cortisone(CT), insulin(INS), glucagon(GC) and growth hormone(GH) using radioimmunologic assessment.Results The glucose metabolism was not affected in mild asphyxia.The highest blood sugar level appeared at 6 h and the lowest at 36 h in serious asphyxic neonate( P <0.01),the level of four hormones rose greatly,they were all significant different from normal control and mild asphyxic group( P <0.01 and 0.05,respectively).Multiple linear regression analysis showed there were significant positive relationship between blood glucose value and level of CT and GC in serious asphyxic neonates.Conclusion CT and GC play an important role in the occurrence of hyperglycemia after asphyxia.Hyperglycemia followed by hypoglycemia after osphyxia shows that glycemic monitoring is very important in serious asphyxia neonate.Using glycocortical hormone and foreign insulin is improper in treating serious asphyxic neonates.