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血清果糖胺与早产儿视网膜病变。

Serum fructosamine and retinopathy of prematurity.

机构信息

Department of Neonatology, Zekai Tahir Burak Maternity and Teaching Hospital, Ankara, Turkey.

出版信息

Indian J Pediatr. 2011 Dec;78(12):1503-9. doi: 10.1007/s12098-011-0515-9. Epub 2011 Jul 6.

Abstract

OBJECTIVE

To determine whether serum fructosamine which is a good marker for detecting hyperglycemia during the previous 2 to 3 wk in infants could predict the development of retinopathy of prematurity in very low birth weight infants.

METHODS

One hundred sixty seven premature infants who had a birth weight of < 1500 g and a gestational age of less than 32 wk were investigated in the present study. Blood glucose was measured at the bedside and infants were recorded as hyperglycemic if their mean blood glucose levels were higher than 150 mg/dL. Serum corrected fructosamine level was obtained from the cord blood at birth and after the first month of life. The infants' eyes were examined by ophthalmologists to detect retinopathy of prematurity at the gestational age of 32 wk or at four wk after birth, whichever came first.

RESULTS

Corrected fructosamine was 319.6 ± 59.6 and 272.8 ± 50.6 mmol/l for group 1 on 1(st) and 30(th) day respectively; 320 ± 61.7 and 268.2 ± 47.3 mmol/l for groups 2 + 3 on 1(st) and 30(th) day respectively which did not differ between groups (p = 0.766 and p = 0.665), whereas duration of hyperglycemia was 1.69 ± 1.1 day in group 1 compared with 3.05 ± 2.4 day in groups 2 + 3 which was significantly different (p = 0.019). The multivariate regression analysis indicated that the duration of hyperglycemia in days was significantly correlated with the development of retinopathy of prematurity (OR 3.26; 95% CI 1.09-9.80; p = 0.035).

CONCLUSIONS

Although the duration of hyperglycemia may contribute to the development of retinopathy of prematurity, serum corrected fructosamine does not have a good predictive value in developing retinopathy of prematurity in very-low-birth-weight (VLBW) infants.

摘要

目的

确定血清果糖胺是否可以作为检测过去 2 至 3 周内婴儿高血糖的良好标志物,从而预测极低出生体重儿(VLBW)中早产儿视网膜病变(ROP)的发生。

方法

本研究共调查了 167 名出生体重<1500g、胎龄<32 周的早产儿。床边测量血糖,如果平均血糖水平高于 150mg/dL,则记录为高血糖。在出生时和出生后第一个月从脐血中获得血清校正果糖胺水平。在妊娠 32 周或出生后 4 周(以先发生者为准),由眼科医生检查婴儿的眼睛,以检测早产儿视网膜病变。

结果

第 1 天,第 1 组的校正果糖胺分别为 319.6±59.6mmol/L 和 272.8±50.6mmol/L;第 2+3 组分别为 320±61.7mmol/L 和 268.2±47.3mmol/L,两组之间无差异(p=0.766 和 p=0.665);而第 1 组的高血糖持续时间为 1.69±1.1 天,第 2+3 组为 3.05±2.4 天,差异有统计学意义(p=0.019)。多变量回归分析表明,高血糖持续时间(天)与 ROP 的发生显著相关(OR 3.26;95%CI 1.09-9.80;p=0.035)。

结论

尽管高血糖的持续时间可能导致 ROP 的发生,但血清校正果糖胺对预测 VLBW 婴儿 ROP 的发生并无良好的预测价值。

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