Turai Réka, Schandl Márton Ferenc, Dergez Timea, Vass Réka Anna, Kvárik Tímea, Horányi Eszter, Balika Dorottya, Mammel Barbara, Gyarmati Judit, Fónai Fruzsina, Vida Gabriella, Funke Simone, Gaál Valéria, Reglődi Dóra, Ertl Tibor
Klinikai Központ, Szülészeti és Nőgyógyászati Klinika, Neonatológiai Tanszék, Pécsi Tudományegyetem, Általános Orvostudományi Kar Pécs, Édesanyák útja 17., 7624.
Bioanalitikai Intézet, Pécsi Tudományegyetem, Általános Orvostudományi Kar Pécs.
Orv Hetil. 2019 Aug;160(32):1270-1278. doi: 10.1556/650.2019.31455.
During recent decades, the perinatal mortality of extremely low-birth weight infants has decreased. An important task is to recognize complications of prematurity. We made an attempt to explore the relationship between complications of prematurity and neonatal hyperglycemia. From 1 January 2014 to 31 December 2017, 188 infants with birth weight below 1000 g were admitted. For each infant, the frequencies of hyperglycemia (blood glucose >8.5 mmol/l), retinopathy of prematurity, intraventricular hemorrhage, and bronchopulmonary dysplasia were determined. Animal studies were performed in Sprague Dawley rats. Hyperglycemia was achieved by intraperitoneal injection of streptozotocin (100 mg/kg). On the 7th day of life, aorta sections were prepared and stained with hematoxylin eosin. Wall thickness was measured using QCapture Pro 7 image analysis software. The mean ± SD gestational age and birth weight were 27.1 ± 2.2 weeks and 814.9 ± 151.9 g; 33 infants (17.5%) died. Hyperglycemia was confirmed in 62 cases (32.9%), and insulin treatment was given to 43 infants (22.8%). The gestational age and birth weight of the hyperglycemic infants were significantly lower (p<0.001), the incidence of severe retinopathy (p = 0.012) and the mortality of insulin-treated patients were higher (p = 0.02) than in normoglycemic infants. Among survivors (n = 155), we found by logistic regression analysis that hyperglycemia was a risk factor for severe retinopathy (p<0.001). In the rat model, neonatal hyperglycemia caused significant thickening of the aortic wall. Our studies indicate that hyperglycemia is common in extremely low birth-weight infants. Monitoring of these infants for retinopathy of prematurity, kidney dysfunction, and hypertension is recommended. Orv Hetil. 2019; 160(32): 1270-1278.
在最近几十年中，极低出生体重儿的围产期死亡率有所下降。一项重要任务是识别早产并发症。我们试图探讨早产并发症与新生儿高血糖之间的关系。2014年1月1日至2017年12月31日，收治了188例出生体重低于1000克的婴儿。对于每例婴儿，测定高血糖（血糖>8.5 mmol/l）、早产儿视网膜病变、脑室内出血和支气管肺发育不良的发生频率。在斯普拉格-道利大鼠身上进行了动物研究。通过腹腔注射链脲佐菌素（100 mg/kg）诱导高血糖。在出生后第7天，制备主动脉切片并用苏木精伊红染色。使用QCapture Pro 7图像分析软件测量壁厚。平均胎龄±标准差为27.1±2.2周，出生体重为814.9±151.9克；33例婴儿（17.5%）死亡。62例（32.9%）确诊为高血糖，43例婴儿（22.8%）接受了胰岛素治疗。高血糖婴儿的胎龄和出生体重显著更低（p<0.001），严重视网膜病变的发生率（p = 0.012）以及接受胰岛素治疗患者的死亡率更高（p = 0.02），高于血糖正常的婴儿。在幸存者（n = 155）中，我们通过逻辑回归分析发现高血糖是严重视网膜病变的危险因素（p<0.001）。在大鼠模型中，新生儿高血糖导致主动脉壁显著增厚。我们的研究表明，高血糖在极低出生体重儿中很常见。建议对这些婴儿进行早产儿视网膜病变、肾功能障碍和高血压的监测。《匈牙利医学周报》。2019年；160(32): 1270 - 1278。
