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极低出生体重患病婴儿的肾功能:4. 葡萄糖排泄

Renal function in sick very low birthweight infants: 4. Glucose excretion.

作者信息

Wilkins B H

机构信息

Department of Child Health, Bristol University.

出版信息

Arch Dis Child. 1992 Oct;67(10 Spec No):1162-5. doi: 10.1136/adc.67.10_spec_no.1162.

Abstract

Renal glucose excretion was measured on 239 occasions in a sample of 36 infants of 25.5-33 weeks' gestation, birth weight 720-2000 g, between the ages of 0.5 and 32 days. Glucose was invariably present in urine from the first day. Fractional glucose excretion varied widely from 0.1% to 90% of filtered glucose and glucose excretion rate was up to 15.5 mmol/kg/day and was higher in the most immature infants, especially below 28 weeks' gestation. The highest values were in association with hyperglycaemia between 5 and 15 days but there was no consistent plasma glucose threshold with frequent glucose spillage at normal blood glucose concentrations. There was some correlation with sodium excretion in the first week suggesting that in the absence of hyperglycaemia with a normal filtered glucose load, glucose excretion is caused by proximal tubular immaturity.

摘要

对36名孕龄25.5 - 33周、出生体重720 - 2000克的婴儿进行了239次测量,记录其0.5至32日龄期间的肾脏葡萄糖排泄情况。从出生第一天起,尿液中就始终含有葡萄糖。葡萄糖排泄分数在过滤葡萄糖的0.1%至90%之间变化很大,葡萄糖排泄率高达15.5 mmol/kg/天,在最不成熟的婴儿中更高,尤其是孕龄低于28周的婴儿。最高值与5至15天的高血糖有关,但在正常血糖浓度下频繁出现葡萄糖溢出时,没有一致的血浆葡萄糖阈值。第一周时,葡萄糖排泄与钠排泄存在一定相关性,这表明在没有高血糖且过滤葡萄糖负荷正常的情况下,葡萄糖排泄是由近端肾小管不成熟引起的。

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本文引用的文献

1
Reducing sugars in the urine and blood of premature babies.早产儿尿液和血液中的还原糖
Arch Dis Child. 1957 Oct;32(165):417-21. doi: 10.1136/adc.32.165.417.
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Maximal tubular reabsorption of glucose in infants and children.
Acta Paediatr Scand. 1972 Jul;61(4):413-20. doi: 10.1111/j.1651-2227.1972.tb15856.x.
10
Osmotic diuresis.渗透性利尿
N Engl J Med. 1974 Oct 3;291(14):714-20. doi: 10.1056/NEJM197410032911408.

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