早产儿血糖及皮质醇水平变化的临床研究

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:108例早产儿行血糖及皮质醇监测,并以65例足月儿为对照组。分低血糖组和高血糖组进行比较分析。对早产儿日龄、胎龄、输糖、危重度、皮质醇水平等因素进行Logistic多元逐步回归分析。结果:早产儿发生血糖异常均高于对照组(P<0.05),一般早产儿组以低血糖为主,发生率35.4%,高危早产儿组以高血糖多见,发生率39.5%,两组低血糖发生率无显著性差异,而高血糖发生率有显著性差异(P<0.05)。一般早产儿组早期皮质醇水平低于足月儿组,而高危早产儿组明显高于足月儿组,3组比较有显著性差异。Logistic多元逐步回归分析表明,胎龄、日龄、未静脉输糖是影响早产儿的血糖的高危因素,而危重度、静脉输糖、皮质醇水平是影响高血糖的高危因素。结论:早产儿血糖紊乱发生率高,危重疾病能激发早产儿应激反应,早产儿血糖紊乱有一定特点及高危因素。加强早产儿血糖监测,并予合理的输液、输糖管理可有效防治早产儿血糖紊乱。

The clinical research on changes of the level of blood glucose and cortisol in preterm infant

Objective:To investigate the feature of blood glucose disorder and factors on blood glucose change in preterm infant .Methods:Checking the blood glucose and cortisol concentrations in 108 premature infant compared to 65 cases term infants.Seven factors incluing sex,age,gestational age,birth weight, degrees of severity, cortisol concentration,vein transfusion glucose were analyzed by logistic multiple stepwise regression analysis.Results:The blood glucose disorder was significantly higher in premature infant than that of control group(P<0.05).The merbidity of hypoglycemia is high in generic premature infant(23 cases,35.4%). Hyperglycemin was easy to be seen in critical premature infant(17 cases,39.5%). There was not significant difference between general premature infant and critical premature infant in hyperglycemia (P>0.05), whihe in hyperglycemia (P<0.05).Cortisol was significantly lower in generic premature infant than that of control group ,but was significantly higher in critical premature infant than that of control group .The logistic multiple stepwise regression analysis showed that age, gestational age,without vein transfusion glucose were risk factors in hypoglycemia,but degrees of critical illness, vein transfusion glucose,cortisol level lead to hyperglycemia of preterm infant.Conclusion:The incidence of blood glucose disorder in premature infant is significantly higher.Severe illness can resulted in stress in premature infant.There are some featurs and risk factors of blood glucose disorder in premature infant.We can prevent the disarder of blood glucose through moniboring blood glucose and rational transfusion of fluid and glucose.