李欢 尹冬琴 徐文慧 温晓芳

【摘要】 目的：分析极/超低出生体重儿出生后1周内并发高血糖的影响因素。方法：回顾2016年8月—2023年8月在上饶市人民医院新生儿科出生的300例极/超低出生体重儿资料，根据出生后1周内是否并发高血糖（空腹血糖>7 mmol/L）分为正常组（n=220）和异常组（n=80），比较两组资料。结果：出生后1周内高血糖发生率26.67%（80/300），发生时间多在24 h内，平均高血糖持续时间（3.44±0.52）d，首发高血糖浓度平均（9.34±1.03）mmol/L；异常组体重<1 500 g、5 min新生儿Apgar评分≤7分、胎龄<28周比例均高于正常组，差异均有统计学意义（P<0.05）；异常组新生儿母亲年龄≥35岁、妊娠期糖尿病、妊娠期高血压疾病比例均高于正常组，差异均有统计学意义（P<0.05）；异常组新生儿葡萄糖输注速度4～6 mg/（kg·min）、禁食时长≤1 d比例均低于正常组，机械通气、新生儿窒息比例均高于正常组，差异均有统计学意义（P<0.05）；体重、胎龄、5 min新生儿Apgar评分、葡萄糖输注速度、新生儿窒息是极/超低出生体重儿出生后1周内并发高血糖的影响因素（P<0.05）。结论：极/超低出生体重儿出生后1周内高血糖发生率较高，体重、胎龄、5 min新生儿Apgar评分、葡萄糖输注速度、新生儿窒息是其影响因素，临床应针对上述指标针对性预防。

【关键词】 极/超低出生体重儿 新生儿高血糖症 影响因素

Analysis of Influencing Factors of Hyperglycemia in Very/Extremely Low Birth Weight Infants within One Week after Birth/LI Huan， YIN Dongqin， XU Wenhui， WEN Xiaofang. //Medical Innovation of China， 2024， 21（13）： -129

[Abstract] Objective： To analyze the influencing factors of hyperglycemia in very/extremely low birth weight infants within 1 week after birth. Method： The data of 300 very/extremely low birth weight infants born in Department of Neonatology of Shangrao People's Hospital from August 2016 to August 2023 were reviewed. According to the presence or absence of hyperglycemia （fasting blood glucose >7 mmol/L） within 1 week after birth， they were divided into normal group （n=220） and abnormal group （n=80）， and the data of the two groups were compared. Result： The incidence rate of hyperglycemia was 26.67% （80/300） within 1 week after birth， and the occurrence time was mostly within 24 hours， average duration of hyperglycemia was （3.44±0.52） d and the average blood glucose concentration of first hyperglycemia was （9.34±1.03） mmol/L. The proportions of body weight <1，500 g，

5 min neonatal Apgar score ≤7 points and gestational age <28 weeks in abnormal group were higher compared to normal group， the differences were statistically significant （P<0.05）. The proportions of maternal age ≥35 years old， gestational diabetes mellitus and gestational hypertension in abnormal group were higher than those in normal group， with statistical differences （P<0.05）. The proportions of neonatal glucose infusion speed of 4-6 mg/（kg·min） and fasting duration ≤1 d in abnormal group were lower than those in normal group， and the proportions of mechanical ventilation and neonatal asphyxia were higher compared with those in normal group， with statistically significant differences （P<0.05）. Body weight， gestational age， 5 min neonatal Apgar score， glucose infusion speed and neonatal asphyxia were the influencing factors of hyperglycemia in very/extremely low birth weight infants within 1 week after birth （P<0.05）. Conclusion： The incidence rate of hyperglycemia is high in very/extremely low birth weight infants within 1 week after birth， and body weight， gestational age， 5 min neonatal Apgar score， glucose infusion speed and neonatal asphyxia are the influencing factors， and it is necessary to perform targeted prevention on the above indicators.

[Key words] Very/extremely low birth weight infants Neonatal hyperglycemia Influencing factors

First-author's address： Department of Neonatology， Shangrao People's Hospital， Shangrao 334000， China

doi：10.3969/j.issn.1674-4985.2024.13.029

极/超低出生体重儿机体发育不完善，出生后易并发多种新生儿疾病，存在死亡风险，需要临床密切照顾，出生后新生儿相关并发症中以高血糖较为常见，临床调查显示其发生率高达20%～86%[1-2]。新生儿高血糖多发生在新生儿出生1周内，患儿血清葡萄糖浓度异常升高，临床可表现为烦躁、多尿等，严重者可导致死亡或对新生儿远期神经发育产生不利影响，是临床需要重点防治的新生儿疾病类型[3-4]。虽然临床实践总结发现极/超低出生体重儿更易并发高血糖，但目前尚缺乏足够的高质量远期预后证据指导极/超低出生体重儿并发高血糖的临床管理，极/超低出生体重儿高血糖的最佳管理策略尚不清楚。本研究回顾性分析2016年8月—

2023年8月在上饶市人民医院新生儿科出生的300例

极/超低出生体重儿临床资料，使用logistic回归分析影响出生后1周内并发高血糖的因素，为采取有效的防治措施提供证据支持，报道如下。

1 资料与方法

1.1 一般资料