中重度新生儿缺氧缺血性脑病应激性高血糖临床分析

目的 探讨中重度新生儿缺氧缺血性脑病(HIE)应激状态下高血糖及电解质紊乱与疾病预后的关系.方法 回顾性分析73例中重度HIE患儿与同期轻度63例HIE患儿住院期间血糖、电解质变化.结果 中重度HIE患儿较轻度HIE患儿血糖升高,血钠和血钙降低,差异有统计学意义(t=2.172、3.126、3.485,均P<0.05),血钾差异无统计学意义(t=0.488,P>0.05);中重度HIE患儿2个以上器官功能障碍者高血糖、低血钠、低血钙发生率高于1个器官功能障碍者(χ2=4.663～10.664,均P<0.05),器官障碍数与低钾血症、高钾血症发生率无关;中重度HIE患儿高血糖组低钠血症、低钙血症发生率高于血糖正常组(χ2=6.258,4.663,均P<0.05),两组低钾血症及高钾血症发生率差异无统计学意义.结论 中重度HIE患儿早期出现高血糖及低血钠、低血钙者常提示机体存在严重应激反应,并由此促进电解质紊乱,与疾病预后关系密切.

Clinical analysis of stress hyperglycemia and electrolyte imbalance in moderate or severe hypoxic ischemic encephalopathy newborns

Objective To discuss the prognoais after hyperglycemia and electrolyte imbalance caused by stress in moderate or severe hypoxic ischemic encephalopathy newborns. Methods Blood sugar and electrolyte of 73 HIE patients, who hospitalized in our hospitial, including 73 moderate or severe patients and 63 mild patients. Results There was significant difference with increase of serum glucose,decrease of serum sodium and calcium between mod- erate or severe and mild HIE. The rate of hyperglycemia, hyponatremia and hypocalcemia was higher in moderate or severe HIE with 2 or more organ dyafunction than I alone. Conclusion The moderate or severe HIE newborns early time presents the hyperglycemia and the low blood sodium, the low serum calcium often prompts organism existence serious stress response, and prompts electrolyte disorder.