摘要
目的探讨足月新生儿不同血糖水平振幅整合脑电图(amplitude integrated electroencephalogram,aEEG)的特点,为评估低血糖后脑功能状态提供临床依据。方法选取2014年6月至2016年5月中南大学湘雅三医院新生儿科收治的入院即诊断新生儿低血糖的足月新生儿为研究对象,根据住院期间血糖水平最低值分为重度低血糖组(<1.1mmol/L)、中度低血糖组(1.1mmol/L≤血糖<2.2mmol/L)和轻度低血糖组(2.2mmol/L≤血糖<2.8mmol/L);按比例选取同期血糖正常的高危新生儿为对照组。低血糖组患儿在血糖稳定后12h连续aEEG监测4h。对照组在出生后72~120h内连续aEEG监测4h。采用秩和检验对各组新生儿aEEG特点进行比较。结果研究期间共纳入低血糖足月新生儿83例,其中重度低血糖组11例,中度低血糖组32例,轻度低血糖组40例;对照组26例。各组新生儿母亲妊娠期血糖升高比例差异有统计学意义(P<0.05)。重度低血糖组新生儿低血糖持续时间较中度低血糖组及轻度低血糖组延长[38.3(20.7,50.4)h比20.4(15.3,22.6)h、13.7(7.8,19.4)h],血糖波动幅度大[5.0(4.0,5.5)mmol/L比3.5(3.0,3.9)mmol/L、3.3(2.8,3.8)mmol/L],差异均有统计学意义(P<0.05);各组首次出现低血糖时间差异无统计学意义(P>0.05)。aEEG评分显示各组总分及睡眠-觉醒周期评分差异有统计学意义(P<0.05)。重度低血糖组睡眠-觉醒周期评分低于其他各组,差异有统计学意义(P<0.05)。结论重度低血糖后可导致新生儿aEEG改变,以睡眠-觉醒周期改变为主。
Objective To study the characteristics of amplitude integrated electroencephalogram (aEEG) in full-term newborns with different blood glucose levels, so as to provide clinical evidence for assessing brain function after hypoglycemia. Method Full-term neonates admitted to the neonatal ward of the Third Xiangya Hospital of Central South University from June 2014 to May 2016 with the initial diagnosis of hypoglycemia were enrolled to hypoglycemia group. According to the lowest level of blood glucose, infants were assigned to three subgroups, severe hypoglycemia group (<1.1 mmol/L), moderate hypoglycemia group (1.1~<2.2 mmol/L), and mild hypoglycemia group (2.2~<2.8 mmol/L). Time matched asymptomatic term infants, who were admitted to the neonatal ward due to maternal high risks and with normal blood glucose after birth, were enrolled to control group. A 4 h continuous aEEG monitoring was completed for each infant in hypoglycemia group within 12 h after the blood glucose level stabilized. The newborns in control group were given aEEG examination 72~120 h after birth, the duration of monitoring was also 4 h. The aEEG scoring was completed and compared by rank sum test. Result A total of 83 neonates were enrolled in hypoglycemia group, including 11 with severe hypoglycemia, 32 with moderate hypoglycemia, and 40 with mild hypoglycemia. Another 26 neonates with normal blood glucose level were enrolled in control group. The incidence of pregnancy-induced maternal blood glucose elevation was statistically significant among each group (P<0.05). The duration of neonatal hypoglycemia in severe hypoglycemia group was longer than that in moderate hypoglycemia group and mild hypoglycemia group [38.3 (20.7, 50.4) h vs. 20.4 (15.3, 22.6) h, 13.7 (7.8, 19.4) h] (P< 0.05). The range of glucose level in severe hypoglycemia group was larger than that in mild and moderate hypoglycemia group [5.0 (4.0, 5.5) mmol/L vs. 3.5 (3.0, 3.9) mmol/L, 3.3 (2.8, 3.8) mmol/L] (P< 0.05), but there was no significant difference in the onset of first h
作者
唐振
欧阳志翠
胡呐
孙艳燕
朱杏
何利
席琼
黑明燕
Tang Zhen;Ouyang Zhicui;Hu Na;Sun Yanyan;Zhu Xing;He Li;Xi Qiong;Hei Mingyan(Neonatal Division, Department of Pediatrics, The Third Xiangya Hospital of Central South University, Changsha 410013, China)
基金
加拿大健康卫生研究院母婴团队建设课题项目(CTP87518).
关键词
低血糖症
睡眠期
振幅整合脑电图
婴儿
新生
Hypoglycemia
Sleep stages
Amplitude integrated electroencephalogram
Infant, newborn
