中国循证儿科杂志2013，Vol.8Issue(2)：116-121,6.DOI:10.3969/j.issn.1673-5501.2013.02.007
足月新生儿低血糖22例磁共振表现与临床特征
The relationship between the MRI findings and clinical features in 22 full-term infants with neonatal hypoglycemia
摘要
Abstract
Objective To evaluate the relationship between the MRI findings and clinical characteristics in full-term infants with neonatal hypoglycemia. Methods The clinical records of 22 neonates with isolated hypoglycemia who were referred to Children' Hospital of Fudan University from June 1, 2008 to June 30, 2011 were reviewed retrospectively. The patients were divided into two groups according to the early magnetic resonance imaging ( MRI ) findings: MRI - group ( n = 9 ) were patients who showed normal brain imaging while MRI + group ( n = 13 ) were patients who showed abnormal brain imaging finding. The clinical characteristics of neonatal hypoglycemia were compared between two groups. The brain injury patterns identified from early MRI scans were presented. Results The frequencies of risk factors for hypoglycemia were similar in two groups ( P = 0.054 ). The duration when hypoglycemia was first detected was 1( 0. 5 - 17 ) h in MRI - group and 46. 6( 12. 7 - 78. 3 ) h in MRI + group, respectively, P = 0. 000. MRI - group established stable blood glucose levels faster than the MRI + group, ( 54. 1 ± 18. 2 ) h vs ( 71. 6 ± 15. 1 ) h, P = 0. 023. The occurrences of symptoms were more frequent in MRI + group than MRI - group ( P = 0. 000 ). Among MRI + group, 10 had predominant bilateral parieto-occipital cortex and subcortical white matter abnormalities, 1 had unilateral occipital and parietal area lesions, 2 had punctate white matter lesions in periventricular region or centrum semiovale. Conclusions Screening and management of babies at risk for neonatal hypoglycemia are recommended. Infants who were identified less than 12 hours of postnatal age remained asymptomatic, and there were no changes in the MRI imaging. The duration from birth till establishment of the stable blood glucose levels might be suggestive of association with neuroimaging changes and long-term neurological changes. The most common area of hypoglycemia-associated brain injury was in the parietal and occipital lobes.关键词
低血糖/新生儿/脑损伤/磁共振成像Key words
Hypoglycemia/ Newborn/ Brain injury/ Magnetic resonance imaging引用本文复制引用
顾秋芳,胡黎园,陈超,曹云,邵肖梅,程国强,王来栓,朱珍,周文浩..足月新生儿低血糖22例磁共振表现与临床特征[J].中国循证儿科杂志,2013,8(2):116-121,6.基金项目
上海市卫生局课题:新生儿低血糖脑损伤的MRI研究(2008192) （2008192）
