Cowett R M, Howard G M, Johnson J, Vohr B
Department of Pediatrics, Women and Infants Hospital of Rhode Island, Providence, USA.
Biol Neonate. 1997;71(1):31-6. doi: 10.1159/000244394.
Imprecise control of glucose homeostasis is a hallmark of neonatal glucose metabolism. A relatively wide range of glucose concentrations is considered 'euglycemic' (2.22-6.94 mmol/l, 40-125 mg/dl) in the neonatal period. We investigated the effects of a wide range of glucose concentrations on brain stem conduction time (BCT) I-V interpeak latency or prolonged wave V latency. Neonates were assessed by brain stem auditory-evoked response followed immediately by heelstick sampling to determine the blood glucose concentration. Twenty-seven appropriate for gestational age (AGA) term neonates (birth weight 3,245 +/- 766 g, mean +/- SD; gestational age 39 +/- 2 weeks) were studied 3.1 +/- 3.7 days after birth. Twenty-three AGA preterm neonates (birth weight 2,175 +/- 477 g; gestational age 35 +/- 1 weeks) were studied 6.0 +/- 7.2 days after birth. Brain stem conduction time wave I-V interpeak latency and wave V latency were determined in two trials using a Grason-Stadler ABR screener at a 60-decibel stimulation level in the right ear. Neonates were studied between 33 and 40 weeks gestational age. Although the blood glucose concentration ranged from 1.38 to 6.83 mmol/1 (25-123 mg/dl), there was no correlation between either brain stem conduction time wave I-V interpeak latency or wave V latency and blood glucose concentration. We conclude that alterations in glucose concentration within the generally accepted neonatal euglycemic range do not effect the functional status of the brain stem auditory pathway. We suggest that the data can be interpreted to affirm that tighter clinical control of glucose homeostasis is probably not required in the neonatal period.
葡萄糖稳态控制不精确是新生儿葡萄糖代谢的一个特征。在新生儿期，相对较宽范围的葡萄糖浓度被认为是“正常血糖”（2.22 - 6.94毫摩尔/升，40 - 125毫克/分升）。我们研究了较宽范围的葡萄糖浓度对脑干传导时间（BCT）I - V峰间期潜伏期或V波潜伏期延长的影响。通过脑干听觉诱发电位对新生儿进行评估，随后立即足跟采血以测定血糖浓度。对27名适于胎龄（AGA）的足月儿（出生体重3245±766克，均值±标准差；胎龄39±2周）在出生后3.1±3.7天进行了研究。对23名AGA早产儿（出生体重2175±477克；胎龄35±1周）在出生后6.0±7.2天进行了研究。使用Grason - Stadler ABR筛查仪在右耳60分贝刺激水平下通过两项试验测定脑干传导时间、I - V峰间期潜伏期和V波潜伏期。研究的新生儿胎龄在33至40周之间。尽管血糖浓度范围为1.38至6.83毫摩尔/升（25 - 123毫克/分升），但脑干传导时间、I - V峰间期潜伏期或V波潜伏期与血糖浓度之间均无相关性。我们得出结论，在普遍接受的新生儿正常血糖范围内，葡萄糖浓度的改变不会影响脑干听觉通路的功能状态。我们建议，这些数据可以解释为证实新生儿期可能不需要对葡萄糖稳态进行更严格的临床控制。
