新生儿低血糖症中的脑损伤：一项基于医院的队列研究。
Brain Injury in Neonatal Hypoglycemia: A Hospital-Based Cohort Study.
作者信息
Gu Mei-Hong, Amanda Fanny, Yuan Tian-Ming
机构信息
Department of Neonatology, Children's Hospital, Zhejiang University School of Medicine, Hangzhou, P.R. China.
出版信息
Clin Med Insights Pediatr. 2019 Aug 8;13:1179556519867953. doi: 10.1177/1179556519867953. eCollection 2019.
BACKGROUND
Neonatal hypoglycemia is more prevalent and can cause severe neurological sequelae. The objective of this study was to assess the patterns of neuroradiologic changes in neonatal hypoglycemia.
METHODS
A retrospective cohort study was conducted on 66 neonatal hypoglycemia patients, and the magnetic resonance imaging (MRI) and clinical records were reviewed.
RESULTS
Magnetic resonance imaging showed evidences of abnormality in 54.54% (36 of 66) of hypoglycemic infants. The most common abnormal findings were located on the parietal and occipital lobes of the brains. The number of days with hypoglycemia was significantly higher for abnormal MRI infants ( < .001), and prolonged/recurrent hypoglycemia was remarkably distinguished for abnormal MRI infants ( < .001). Patients with abnormal MRI findings did not have a lower blood glucose than infants without abnormal MRI findings ( > .05), but the lowest blood glucose was significantly lower for the patients with seizures ( < .01).
CONCLUSIONS
The pattern of bilateral occipital cortical injury is the most common abnormality for neonatal hypoglycemia. The number of days with hypoglycemia, not the lower blood glucose, was significantly related to abnormal MRI infants.
背景
新生儿低血糖较为常见，可导致严重的神经后遗症。本研究的目的是评估新生儿低血糖时神经影像学变化的模式。
方法
对66例新生儿低血糖患者进行回顾性队列研究，并对磁共振成像（MRI）和临床记录进行回顾。
结果
磁共振成像显示54.54%（66例中的36例）低血糖婴儿有异常表现。最常见的异常发现位于大脑顶叶和枕叶。MRI异常婴儿的低血糖天数显著更多（<0.001），MRI异常婴儿的低血糖持续时间延长/反复低血糖情况也显著不同（<0.001）。MRI有异常发现的患者血糖并不比MRI无异常发现的婴儿低（>0.05），但癫痫患者的最低血糖显著更低（<0.01）。
结论
双侧枕叶皮质损伤模式是新生儿低血糖最常见的异常。低血糖天数而非更低的血糖水平与MRI异常婴儿显著相关。
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