应用振幅整合脑电图评价妊娠期糖尿病对新生儿脑发育的影响

发布时间：2018-07-07 18:45

本文选题：妊娠期糖尿病 + 脑发育　；参考：《发育医学电子杂志》2016年04期

【摘要】：目的采用振幅整合脑电图(amplitude-integrated electroencephalogram,aEEG),评价妊娠期糖尿病(gestational diabetes mellitus,GDM)母亲血糖控制情况对新生儿脑发育的影响。方法选取2009年1月至2015年4月在北京大学第一医院妇产科分娩,且母亲诊断为GDM的足月新生儿为研究对象,共纳入患儿115例。根据血糖控制情况,分为满意组与不满意组,每组再分为饮食运动与胰岛素治疗两个亚组。新生儿出生后30分钟内检测血糖;出生后72小时内进行aEEG监测,以振幅、原始脑电和睡眠周期任一项异常为aEEG异常。超声测量侧脑室后角比值,该比值0.5为异常。采用χ~2检验进行统计分析,比较GDM母亲血糖控制情况对新生儿aEEG结果的影响。结果血糖控制满意组新生儿aEEG异常的比例低于血糖控制不满意组[13%(11/88)与85%(23/27),χ~2=52.4,P0.05]。血糖控制满意者中,饮食运动组与胰岛素组的新生儿aEEG异常比例分别为11%(8/74)与21%(3/14),差异无统计学意义(χ~2=1.2,P0.05)。血糖控制不满意者中,饮食运动组与胰岛素组的新生儿aEEG异常比例分别为83%(20/24)与100%(3/3),差异也无统计学意义(χ~2=0.6,P0.05)。共有34例患儿aEEG异常,其中23例轻度振幅异常,无重度异常者;34例患儿的原始脑电均不连续。新生儿血糖正常组与低血糖组aEEG异常的比例分别为27%(11/41)与31%(23/74),差异无统计学意义(χ~2=0.2,P0.05)。72例新生儿aEEG与头颅B超结果均正常,13例两项检查结果均异常,诊断符合率为74%(85/115)。结论 GDM母亲血糖控制不满意,对新生儿脑发育影响较大;采用aEEG可帮助评价新生儿的脑发育情况。
[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.
【作者单位】：北京大学第一医院儿科;民航总医院儿科;
【基金】：北京市科学技术委员会资助项目(Zl61100002616011)
【分类号】：R714.256

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