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Lancet:食糖舌下给药可治疗小儿低血糖症

2014-04-16 佚名 www.thelancet.com

Deborah Harris及其同事研究发现,在具有低血糖危险因素的婴儿中,葡萄糖凝胶作为一种非侵入性治疗方法,能安全有效的治疗新生儿低血糖。而且,葡萄糖凝胶还可降低患儿重症监护病房入住率,以及对静脉输注葡萄糖和人工喂养的需求。该研究结果发表在2013年12月21日的The Lancet杂志上。 在低血糖发生率和漏诊率均比较高的资源匮乏地区,迫切需要这种治疗方法。然而,葡萄糖凝胶制剂的费用和

Deborah Harris及其同事研究发现,在具有低血糖危险因素的婴儿中,葡萄糖凝胶作为一种非侵入性治疗方法,能安全有效的治疗新生儿低血糖。而且,葡萄糖凝胶还可降低患儿重症监护病房入住率,以及对静脉输注葡萄糖和人工喂养的需求。该研究结果发表在2013年12月21日的The Lancet杂志上。【原文下载】

在低血糖发生率和漏诊率均比较高的资源匮乏地区,迫切需要这种治疗方法。然而,葡萄糖凝胶制剂的费用和实用性限制了其的使用。

在非洲马里和布基纳法索,Hubert Barennes教授及其团队评估食糖舌下给药纠正儿童低血糖的有效性和安全性,而舌下黏膜途径富含载体介导的葡萄糖运输系统。Hubert Barennes教授等发现食糖舌下给药比口服给药吸收更快。10分钟内患儿血糖浓度增加达到2mmol/l,并且,20分钟后,64%的患儿血糖浓度升高超高3.3mmol/l。

Hubert Barennes教授等指出由于羟甲基纤维素可延缓葡萄糖的吸收,对疑羟甲基纤维素作为安慰剂使用表示质疑,而且,这也可假释安慰剂组失败的原因。

最终,Hubert Barennes教授与Harris教授的意见达成一致,使用小剂量食糖可预防反跳性低血糖。舌下表面积允许葡萄糖吸收的量有限(0.2g/kg),而且,舌下葡萄糖载体的饱和性也限制了大剂量葡萄糖的使用。但可通过食糖重复舌下给药预防反跳性低血糖。

Hubert Barennes教授同时提出,在今后的研究中,应评估新生儿葡萄糖凝胶或食糖舌下给药的剂量和可行性。

原始出处:


Barennes H1, Willcox ML2, Graz B3, Pussard E4.Sublingual sugar for infant hypoglycaemia.Lancet. 2014 Apr 5;383(9924):1208. doi: 10.1016/S0140-6736(14)60601-2.【原文下载】

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