标题：HIE新生儿血糖与脑损伤的相关性研究

      作者：唐毅，曾得润，刘美珍    (攀枝花市攀钢集团总医院儿科，四川 攀枝花 617023)

      卷次： 2018年29卷4期

      【摘要】 目的 探讨缺氧缺血性脑病(HIE)新生儿血糖与脑损伤的相关性。方法 选取 2016年 1~8月期间在攀枝花市攀钢集团总医院诊治的HIE新生儿 100例(HIE组)，以同期分娩的健康新生儿 100例为对照(对照组)，检测血糖及S-100蛋白和神经元特异性烯醇化酶(NSE)，分析不同病情严重程度患儿血糖及S-100蛋白和NSE变化。结果 HIE组新生儿的血糖、S-100蛋白和NSE水平分别为(7.27±1.58) mmol/L、(18.63±6.86) ng/mL、(23.52±8.12) ng/mL，高于对照组的(6.88±0.69) mmol/L、(0.12±0.07) ng/mL、(6.12±1.24) ng/mL，差异均有统计学意义(P<0.05)；HIE组新生儿中，低血糖19例、高血糖25例，血糖异常率为44.00% (44/100)；不同病情严重程度分度HIE患儿血糖及S-100蛋白和NSE水平比较，轻度低于中度及重度、中度低于重度，差异均有统计学意义(P<0.05)；不同病情严重程度分度HIE患儿血糖异常率比较，轻度[25.00% (9/36)]低于中度[46.81% (22/47)]及重度[76.47% (13/17)]、中度低于重度，差异均有统计学意义(P<0.05)；血糖水平早产儿为(5.22±1.35) mmol/L，低于足月儿的(7.65±1.67) mmol/L，S-100蛋白和NSE水平早产儿分别为(21.43±5.23) ng/mL、(25.11±4.67) ng/mL，高于足月儿的(17.35±5.37) ng/mL、(20.57±3.55) ng/mL，差异均有统计学意义(P<0.05)；早产儿血糖异常率为 62.50% (20/32)，高于足月儿的 35.29%(24/68)，差异有统计学意义(P<0.05)。结论 HIE新生儿血糖水平明显存在紊乱，低血糖与高血糖均会出现，血糖紊乱与脑损伤程度关系密切。
      【关键词】 缺氧缺血性脑病；血糖；脑损伤
      【中图分类号】 R722.1 【文献标识码】 A 【文章编号】 1003—6350（2018）04—0488—03

Correlation between blood glucose and brain damage in neonates with hypoxic-ischemic encephalopathy.
TANGYi, ZENG De-run, LIU Mei-zhen. Department of Pediatrics, General Hospital of Panzhihua Iron and Steel Group, Panzhihua617023, Sichuan, CHINA
【Abstract】 Objective To investigate the correlation between blood glucose and brain damage in neonates withHIE. Methods From January 2016 to August 2016, 100 neonates with HIE (HIE group) and 100 healthy neonates (con-trol group) in General Hospital of Panzhihua Iron and Steel Group were selected. Blood glucose and S-100 protein andneuron specific enolase (NSE) were detected, and the changes of blood glucose and S-100 protein and NSE in children with differ-ent severity were analyzed. Results The levels of blood glucose and S-100 protein and NSE were (7.27±1.58) mmol/L, (18.63±6.86) ng/mL, (23.52±8.12) ng/mL in the HIE group versus (6.88±0.69) mmol/L, (0.12±0.07) ng/mL, (6.12±1.24) ng/mL in thecontrol group (P<0.05). In the HIE group, there were 19 cases of hypoglycemia and 25 cases of hyperglycemia, and theabnormal rate of blood glucose was 44.00% (44/100). Among the patients with different severity of HIE, blood glucoseand S-100 protein and NSE levels were significantly different (P<0.05), which were lower in mild than moderate andsevere patients (P<0.05) and in moderate than severe patients (P<0.05). The differences in the abnormal rate ofblood glucose were also statistically significant among patients with different severity of HIE (P<0.05): 25.00% (9/36) for mild, 46.81% (22/47) for moderate, and 76.47% (13/17) for severe (P<0.05). The blood glucose levels was (5.22±1.35) mmol/L in premature infant, as compared with (5.22±1.35) mmol/L in term infants (P<0.05). The S-100 proteinand NSE levels were (21.43±5.23) ng/mL, (25.11±4.67) ng/mL in premature infant versus (17.35±5.37) ng/mL, (20.57±3.55) ng/mL in term infants (P<0.05). The abnormal rate of blood glucose was 62.50% (20/32) with premature infant and35.29% (24/68) with term infants (P<0.05). Conclusion Blood glucose levels in neonates with HIE are obvious disor-der, and both hypoglycemia and hyperglycemia can occur. The disorder has close relationships to brain damage.
      【Key words】 Hypoxic-ischemic encephalopathy; Blood glucose; Brain damage·论 著·doi:10.3969/j.issn.1003-6350.2018.04.013基金项目：四川省攀枝花市科技局科研基金资助项目(编号：2015CY-S-16-12)