本文選題：妊娠期糖尿病 + 腦發(fā)育��； 參考：《發(fā)育醫(yī)學電子雜志》2016年04期

【摘要】：目的采用振幅整合腦電圖(amplitude-integrated electroencephalogram,aEEG),評價妊娠期糖尿病(gestational diabetes mellitus,GDM)母親血糖控制情況對新生兒腦發(fā)育的影響。方法選取2009年1月至2015年4月在北京大學第一醫(yī)院婦產(chǎn)科分娩,且母親診斷為GDM的足月新生兒為研究對象,共納入患兒115例。根據(jù)血糖控制情況,分為滿意組與不滿意組,每組再分為飲食運動與胰島素治療兩個亞組。新生兒出生后30分鐘內(nèi)檢測血糖;出生后72小時內(nèi)進行aEEG監(jiān)測,以振幅、原始腦電和睡眠周期任一項異常為aEEG異常。超聲測量側腦室后角比值,該比值0.5為異常。采用χ~2檢驗進行統(tǒng)計分析,比較GDM母親血糖控制情況對新生兒aEEG結果的影響。結果血糖控制滿意組新生兒aEEG異常的比例低于血糖控制不滿意組[13%(11/88)與85%(23/27),χ~2=52.4,P0.05]。血糖控制滿意者中,飲食運動組與胰島素組的新生兒aEEG異常比例分別為11%(8/74)與21%(3/14),差異無統(tǒng)計學意義(χ~2=1.2,P0.05)。血糖控制不滿意者中,飲食運動組與胰島素組的新生兒aEEG異常比例分別為83%(20/24)與100%(3/3),差異也無統(tǒng)計學意義(χ~2=0.6,P0.05)。共有34例患兒aEEG異常,其中23例輕度振幅異常,無重度異常者;34例患兒的原始腦電均不連續(xù)。新生兒血糖正常組與低血糖組aEEG異常的比例分別為27%(11/41)與31%(23/74),差異無統(tǒng)計學意義(χ~2=0.2,P0.05)。72例新生兒aEEG與頭顱B超結果均正常,13例兩項檢查結果均異常,診斷符合率為74%(85/115)。結論 GDM母親血糖控制不滿意,對新生兒腦發(fā)育影響較大;采用aEEG可幫助評價新生兒的腦發(fā)育情況。
[Abstract]:Objective to evaluate the effect of maternal blood glucose control on neonatal brain development in gestational diabetes mellitus (gestational diabetes mellitusus) by amplitude-integrated electroencephalogram (amplitude-integrated). Methods from January 2009 to April 2015, 115 newborns with GDM diagnosed as GDM were enrolled in the study, which were delivered in Department of Gynecology and Obstetrics in the first Hospital of Peking University. According to the blood glucose control, the patients were divided into satisfactory group and unsatisfactory group, and each group was divided into two subgroups: diet, exercise and insulin therapy. The blood glucose was detected within 30 minutes after birth, and the AEEG was monitored within 72 hours after birth. The amplitude, the original EEG and the sleep cycle were all abnormal as a result of AEEG abnormality. The ratio of posterior horn of lateral ventricle was measured by ultrasound, and the ratio of 0.5 was abnormal. Statistical analysis was made by 蠂 ~ 2 test to compare the effect of blood glucose control of GDM mothers on the results of aEEG of newborns. Results the rate of abnormal AEEG in the group of satisfactory blood glucose control was lower than that in the group of unsatisfactory control of blood glucose [13% (11 / 88) vs 85% (23 / 27), 蠂 2 + 52.4% (P0.05)]. The abnormal rates of AEEG in diet exercise group and insulin group were 11% (8 / 74) and 21% (3 / 14), respectively. The abnormal rates of AEEG in diet exercise group and insulin group were 83% (20 / 24) and 100% (3 / 3), respectively. There were 34 cases of abnormal AEEG, of which 23 cases were mild amplitude abnormality, 34 cases without severe abnormality had discontinuous original EEG. The rates of abnormal AEEG in normal neonates and hypoglycemic group were 27% (11 / 41) and 31% (23 / 74), respectively. There was no significant difference (蠂 2 / 0. 2 P 0.05). 72 cases of neonatal AEEG and brain B ultrasound were normal and 13 cases were abnormal. The diagnostic coincidence rate was 74% (85 / 115). Conclusion the control of blood glucose in GDM mothers is unsatisfactory and has a great effect on neonatal brain development, and the use of AEEG can help to evaluate the brain development of newborns.
【作者單位】： 北京大學第一醫(yī)院兒科;民航總醫(yī)院兒科;
【基金】：北京市科學技術委員會資助項目(Zl61100002616011)
【分類號】：R714.256

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