高血糖是极低出生体重儿早期死亡和发病的一个风险因素。

Hyperglycemia is a risk factor for early death and morbidity in extremely low birth-weight infants.

作者信息

Hays Stephane P, Smith E O'Brian, Sunehag Agneta L

机构信息

USDA/ARS Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, 1100 Bates St, Houston, TX 77030, USA.

出版信息

Pediatrics. 2006 Nov;118(5):1811-8. doi: 10.1542/peds.2006-0628.

DOI:10.1542/peds.2006-0628

PMID:17079549

Abstract

OBJECTIVES

The objectives of this study were to determine the prevalence of hyperglycemia in extremely low birth-weight infants and to determine whether hyperglycemia increases the risk of early adverse outcomes (death or intraventricular hemorrhage of grade 3 or 4) and/or affects the length of hospital stay among survivors without intraventricular hemorrhage.

METHODS

The charts of all extremely low birth-weight infants (n = 93) admitted to Texas Children's Hospital (Houston, TX) during 2001 were reviewed. The highest daily blood glucose concentrations, highest dopamine infusion rates, highest daily percentage of inspired oxygen, and mean blood sodium concentrations were averaged over the first week of life or before death or occurrence of grade 3 or 4 intraventricular hemorrhage. Among survivors without severe intraventricular hemorrhage, the time ratio for blood glucose concentrations of >150 mg/dL was calculated.

RESULTS

More than 50% of the infants had persistent blood glucose concentrations of >150 mg/dL during their first week of life. Early adverse outcomes were associated with the average highest daily blood glucose concentration through interaction with the Clinical Risk Index for Babies score and with the average highest daily percentage of inspired oxygen. The length of hospital stay was associated with the time ratio for blood glucose concentrations of >150 mg/dL through interaction with birth weight and the average highest daily percentage of inspired oxygen.

CONCLUSION

These data confirm the high prevalence of hyperglycemia among parenterally fed, extremely low birth-weight infants and show that high blood glucose concentrations increase the risk of early death and grade 3 or 4 intraventricular hemorrhage and the length of hospital stay among survivors without intraventricular hemorrhage, which suggests that prevention and treatment of hyperglycemia may improve the outcomes of extremely low birth-weight infants.

摘要

目的

本研究的目的是确定极低出生体重儿高血糖症的患病率，并确定高血糖症是否会增加早期不良结局（死亡或3级或4级脑室内出血）的风险，和/或影响无脑室内出血的存活者的住院时间。

方法

回顾了2001年期间入住德克萨斯儿童医院（德克萨斯州休斯顿）的所有极低出生体重儿（n = 93）的病历。在出生后第一周或死亡或发生3级或4级脑室内出血之前，对每日最高血糖浓度、最高多巴胺输注率、最高每日吸氧百分比和平均血钠浓度进行平均。在无严重脑室内出血的存活者中，计算血糖浓度>150 mg/dL的时间比。