围产期窒息对新生儿糖代谢影响的研究

THE STUDY ON EFFECT OF GLUCOSE METABOLISM IN PERINATAL WITH ASPHYXIA.

为研究围产期窒息对新生儿血糖及其调节激素的影响 ,对 40例窒息患儿生后 72小时进行连续血糖监测 ,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。结果显示 ,轻度窒息对新生儿糖代谢无影响 ;重度窒息生后 6小时血糖最高 ,36小时最低 (P <0 0 1 )。 4种激素水平明显增高 (P <0 0 1 ) ,多元线性回归分析发现重度窒息后 6～ 1 2小时血糖值与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。结论认为 ,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 ,治疗时不宜应用糖皮质激素和胰岛素。

To study the effect of perinatal asphyxia on glucose metabolism and its regulating hormones, we made a continuous micromonitor of blood sugar level in 40 asphyxiated term newborn during the first 3 days of life and assayed serum concentration of cortisone(CT), insulin (INS), glucagon (GC) and growth hormaone (GH) using radioimmunologic assessment. Results showeed that the glucose metabolism was not effected in mild asphyxia. There were the highest blood sugar level at 6 hrs in serious sphyxic neonates and the lowest at 36 hrs, the level of four hormones rose greatly, which were all significant difference 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 the level of CT and GC in serious asphyxic neonates. Therefore, CT and GC play a important role in the occurrence of hyperglycemia after asphyxia. Hyperglycemia followed by hypoglycemia after hypoxia show that glycemic monitoring is very important in serious asphyxic neonates. Using glycocortical hormone and insulin is improper suitable in treating serious asphyxic neonates to be concidesed.