92例早产儿血糖紊乱高危因素分析

目的探讨早产儿血糖紊乱的高危因素及临床特点。方法采用微量法对92例早产儿进行连续血糖监测。结果血糖持续正常28例（30．5％），异常64例（69．5％）；胎龄〈31周的早产儿（10．7％）无一例血糖持续正常；8例低体重早产儿（1200—1500g）空腹血糖全部异常；高低血糖交替发生18例（19．6％）；恢复正常血糖水平时问平均4．5d，最长达45d；重度窒息组全部异常，其中8例为高血糖，3例高血糖持续不能纠正死亡。结论低出生体重、胎龄、1分钟Apgar评分是早产儿发生血糖紊乱的高危因素，胎龄越小、体重越低、1分钟Apgar评分越低血糖紊乱发生率越高。持续高血糖不能纠正往往预示病情危重预后差。

Analysis of high risk factors of dysglycemia in 92 premature infants

Objective To investigate the high risk factors of dysglycemia in premature infants and its Clinical Characteristics. Methods Peripheral blood glucose level was detected by micromethod in all 92 premature infants. Results In all cases, 28 cases showed normal blood glucose and 64 cases were of dysglycemia, account for 30. 5% and 69. 5% respectively. The premature infants with gestational age less than 31 weeks were all of dysglycemia. All eight infants with low birth weight （ 1 200 - 1 500 g） were of hyperglycemia. In all cases ,there were 18 cases of hyperglycemia and hypoglycemia alternately, account for 19.6%. The average and longest treatment time of returning blood glucose to normal was 4. 5days and 45 days ,respectively. The level of blood glucose in all premature infants with severe asphyxia was abnormal, of which 8 cases was hyperglycemia, and 3 patients died of irreversible hyperglycemia. Conclusion Low birth weight, gestational age and 1 st min Apgar score are the high risk factors of dysglycemia in premature infants, and the lower birth weight, gestational age and I st min Apgar score, the higher the occurrence rate of dysglycemia. Irreversible hyperglycemia may imply the critical condition and poor prognosis.