Objective To explore the correlation between the fluctuation of blood glucose levels and brain damage in neonates with hypoglycemia. Methods The clinical data of 58 cases of neonatal hypoglycemia diagnosed from September 2013 to August 2016 were analyzed retrospectively. According to the results of neonatal cranial MRI and/or amplitude integrated electroencephalogram (aEEG), the neonates were divided into brain injury group and non-brain injury group. The fluctuation index of blood glucose was compared between two groups, and the correlation between the fluctuation of blood glucose level and brain injury was analyzed. Results In these 58 cases, 13 cases were in brain injury group (8 males and 5 females) and 45 cases were in non-brain injury group (27 males and 18 females). The lowest blood glucose (LBG) value in brain injury group was lower than that in non-brain injury group, while the duration of hypoglycemia, maximum blood glucose fluctuations (LAGE), standard deviation of blood glucose (SDBG), and average blood glucose fluctuations (MAGE) were higher than those in non-brain injury group, and they were all significantly different (P all<0.001). Conclusions Whether the hypoglycemia in newborn could lead to the brain injury or not depends not only on the minimum hypoglycaemia level and duration of hypoglycemia, but also on the indicators of glucose variation, such as LAGE, SDBG and MAGE.%目的 探讨低血糖新生儿血糖波动水平与脑损伤的相关性.方法 回顾分析2013年9月—2016年8月确诊的58例低血糖新生儿的临床资料,根据新生儿头颅MRI和/或振幅整合脑电图(aEEG)结果分为脑损伤组和非脑损伤组,比较两组的血糖波动指标,分析血糖波动水平与脑损伤的相关性.结果 58例新生儿中脑损伤组13例(男8例、女5例),非脑损伤组45例(男27例、女18例).脑损伤组新生儿的最低血糖值(LBG)低于非脑损伤组,而低血糖持续时间、最大血糖波动幅度(LAGE)、血糖水平标准差(SDBG)及平均血糖波动幅度(MAGE)均高于非脑损伤组,差异有统计学意义(P均<0.001).结论 低血糖新生儿是否发生脑损伤,除与最低血糖水平及低血糖持续时间有关外,也与LAGE、SDBG及MAGE等血糖变异指标有关,在临床纠正新生儿低血糖时速度不宜过快、幅度不宜过高.
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