摘要
目的 :探讨新生儿窒息后血皮质醇、胰岛素水平动态变化与血糖的关系 ,以利临床正确处理低血糖 ,减少神经系统损害。方法 :采用放射免疫法监测 4 3例新生儿窒息后第 1、3、7d血清皮质醇、胰岛素浓度 ,葡萄糖氧化酶法监测血糖浓度。结果 :新生儿窒息后第 1、3、7d血清皮质醇逐渐降低 (P<0 .0 1) ,血胰岛素水平第 1d显著增高(P<0 .0 1) ,第 3d恢复正常 (<2 0 m IU/L) ;出生第 1d,血皮质醇水平与血糖呈正相关 (r=0 .4 32 ,P<0 .0 1) ,血胰岛素与皮质醇比值 ,低血糖组高于正常血糖组 (P<0 .0 1) ,高胰岛素血症组低血糖发生率 (76 .9% )高于正常胰岛素组 (4 1.2 % ,P<0 .0 5 )。结论 :新生儿窒息后低血糖的发生与暂时性高胰岛素血症及相对低的血皮质醇水平有关。
Objective: To explore the dynamic change of serum cortisol and insulin levels,and their relation with blood glucose concentration in asphyxiated neonates.Methods:The levels of serum cortisol and insulin at d1,d3 and d7 of birth were measured by radioimmunoassay and the concentration of blood glucose was measured with glucose oxidase method in 43 asphyxiated neonates.Results:The levels of serum cortisol at d 1,d 3 and d 7 of birth were gradually decreased (P<0.01).At d1,the incidence of hyperinsulism (>20 mIU/L) was 60.5%.The level of serum insulin reached normal level (≤20 mIU/L) at d3.At d1,the level of serum cortisol was positively related with the level of blood glucose (r=0.432,P<0.01),the ratio of serum insulin and cortisol in hypoglycemia group (0.71±0.71) was significantly higher than that in normal blood glucose group (0.19±0.36,P<0.01).The incidence of hypoglycemia in hyperinsulism group was markedly higher than that in normal serum insulin group (P<0.05).Conclusion:There are temporary hyperinsulism in asphyxiated neonates.Hypoglycemia in asphyxiated neonates is related with hyperinsulism and low serum cortisol level.
出处
《浙江大学学报（医学版）》
CAS
CSCD
2003年第3期253-256,共4页
Journal of Zhejiang University(Medical Sciences)
关键词
新生儿窒息
血清
皮质醇
胰岛素水平
血糖
诊断
Asphyxia neonatorum/diag
Adrenal cortex hormones/blood
Insulin/blood
Blood glucose
