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目的 观察窒息新生儿血糖(BG)、皮质醇(co)、胰岛素(InS)水平变 化,以探讨其临床意思。方法 用微量法和放免法检测40例正常新生儿和50例窒 息新生儿血糖、皮质醇、胰岛素。结果 窒息新生儿脐血BG、InS、Co明显升高,且与 窒息严重程度呈正相关(r值分别为0．36、0．31、0．33)。出生3 d BG和Co水平有所 降低,而InS水平无降低趋势。重度窒息组与对照组相比,各项水平差异显著(P< 0．01),且窒息组3 d时BG、Co水平与脐血相比有明显差异(P<0．05)。结论 应 激状态可造成BG、InS、Co升高,随窒息解除、病情缓解,胰岛素抵抗的恢复较血糖和 皮质醇恢复慢。在窒息抢救时,尤其是重度窒息儿,应密切监测血糖与激素变化,且 慎用糖皮质激素。
Objective To observe the changes of blood sugar (BG), cortisol (CO) and insulin (InS) levels in neonates with asphyxia to explore their clinical significance. Methods The blood glucose, cortisol and insulin in 40 normal newborns and 50 asphyxiated newborns were detected by microdialysis and radioimmunoassay. Results Asphyxial neonatal cord blood BG, InS, Co was significantly increased, and positively correlated with the severity of asphyxia (r values were 0.36,0.31,0.33). The level of BG and Co decreased after 3 days of birth, while the level of InS did not decrease. Compared with the control group, the levels of BG and Co in the severe asphyxia group were significantly different (P <0.01), and the levels of BG and Co in the asphyxia group were significantly different from those in the control group (P <0.05). Conclusion The stress state can cause the increase of BG, InS and Co. With the release of suffocation, the disease is relieved and the recovery of insulin resistance is slower than the recovery of blood glucose and cortisol. Rescue in the suffocation, especially severe suffocation, should be closely monitoring blood glucose and hormone changes, and cautious use of corticosteroids.