Hawdon J M, Aynsley-Green A, Ward Platt M P
Department of Child Health, University of Newcastle upon Tyne.
Arch Dis Child. 1993 Mar;68(3 Spec No):255-61. doi: 10.1136/adc.68.3_spec_no.255.
Neonatal hypoglycaemia is a common clinical problem and the traditional treatment for the condition is intravenous glucose administration. The glycaemic effects of two additional treatments were investigated, in a randomised trial, in 23 neonates who were receiving intravenous glucose as treatment for hypoglycaemia. Eleven infants received an intravenous bolus dose of glucagon (200 micrograms/kg) and 12 infants received intragastric medium chain triglyceride (MCT) (5 ml/kg). Blood concentrations of glucose and intermediary metabolites were measured before and one hour after treatment, and, using stable isotope infusion, glucose production rates were calculated. After glucagon, there was a mean rise in blood glucose concentration of 1.6 mmol/l and in the glucose production rate of 2.6 mg/kg/min. After MCT, there was a small mean rise in blood glucose concentration of 0.4 mmol/l, but the effect of MCT on glucose production rate was variable. Intravenous bolus glucagon administration exerted a glycaemic effect which was associated with an increase in glucose production rate. The use of glucagon, as an alternative treatment to intravenous glucose, should be investigated further.
新生儿低血糖是一个常见的临床问题，该病症的传统治疗方法是静脉输注葡萄糖。在一项随机试验中，对另外两种治疗方法的血糖效应进行了研究，试验对象为23名正在接受静脉输注葡萄糖治疗低血糖的新生儿。11名婴儿接受了静脉推注胰高血糖素（200微克/千克），12名婴儿接受了胃内中链甘油三酯（MCT）（5毫升/千克）。在治疗前和治疗后1小时测量血糖和中间代谢产物的血浓度，并使用稳定同位素输注法计算葡萄糖生成率。注射胰高血糖素后，血糖浓度平均升高1.6毫摩尔/升，葡萄糖生成率平均升高2.6毫克/千克/分钟。给予MCT后，血糖浓度平均小幅升高0.4毫摩尔/升，但MCT对葡萄糖生成率的影响各不相同。静脉推注胰高血糖素产生了血糖效应，这与葡萄糖生成率的增加有关。应进一步研究将胰高血糖素用作静脉输注葡萄糖的替代治疗方法。
