新生儿低血糖及低血糖性脑损伤的研究进展

摘要

Hypoglycemia is a common and early metabolic disease of neonate.Serious and persistent hypoglycemia could result in brain damage.So far the pathogenesis of the disease is on research,but the definition of hypoglycemia,the glucose threshold of intervention,and diagnostic criteria of brain damage are still unclear.The pathogenesis of hypoglycemia is complicated.Brain damage may be related to the specific excitory amino acids receptors,reduced blood flow in occipital lobe,and cerebral hypoxia and ischemia.Diffusion weighted imaging of brain MRI and magnetic resonance spectroscopy are strongly recommended for the diagnosis of brain damage.Besides,clinical manifestation and cerebral function monitor are also included in the diagnosis.The threshold of intervention is suggested as serum glucose concentration with 2.2 ～ 2.6 mmol/L.%低血糖是新生儿早期常见的代谢疾病,严重持续低血糖常引起脑损伤.迄今对其发病机制研究较多,但有关低血糖的定义、干预阈值、脑损伤的诊断标准等尚未明确.低血糖病因复杂.脑损伤与兴奋性氨基酸特异性受体、枕叶血流降低、脑缺氧缺血等有关.脑MRI的弥散加权成像技术、磁共振波谱成像技术对脑损伤的诊断具有重要价值.诊断应包含临床表现、影像学表现和脑功能异常三方面.建议干预阈值为全血血糖2.2～2.6 mmol/L.