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Hypoglycemia

儿科

关键词儿科 疾病 新生儿

词汇介绍

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解析

neonatal 英 /,niːə(ʊ)'neɪt(ə)l/  美 /,nio'netl/

释    义   adj. 新生的;初生的

例    句   Jaundice in adults and older children is not related to neonatal jaundice; it is usually the sign of a health problem. 黄疸在成人和年龄较大的儿童是不相关的新生儿黄疸,这是通常的迹象是一个健康问题。


hypoglycemia美 /,haɪpoglaɪ'simɪə/

释    义   n. 低血糖症;血糖过低

例    句   In the intensive insulin group, 17 percent had severe hypoglycemia compared to just 4 percent of those on standard insulin therapy. 在强化胰岛素治疗组,17%的患者出现了严重低血糖症而标准胰岛素治疗组仅4%出现。

概述

低血糖症是新生儿常见的代谢性疾病,其发病率为3%-11%。目前以静脉血糖<2.2 mmol/L为诊断标准,血糖<2.6 mmol/ L是临床干预的界值。低血糖症是新生儿惊厥的重要病因之一,严重的低血糖症可以影响新生儿中枢神经系统,造成永久性的脑损伤。新生儿低血糖分为暂时性低血糖以及持续性低血糖,新生儿低血糖的发生是在多种因素的影响下导致的。剖宫产患儿出现低血糖可能由于突然中断母亲血糖的供应,患儿尚未完全准备好有关。窒息患儿低血糖和高血糖都比较常见,主要是由于窒息应激有关。病因及临床意义早产儿

Glibenclamide oral suspension: Suitable and effective in patients with neonatal diabetes复制标题

格列本脲口服混悬液对新生儿糖尿病患者的治疗效果

发表时间:2019-05-01

影响因子:3.3

作者: Beltrand Jacques

期刊:Pediatr Diabetes

Neonatal diabetes (NDM) was treated in the same way as type 1 diabetes until elucidation of the genetic basis of with the disease was shown to involve activating mutations in KCNJ11 or ABCC81. This discovery led to the first example of precision medicine in diabetes and to the radically different, specific and successful therapeutic approach consisting in giving oral sulfonylureas (glibenclamide, also known as glyburide) instead of insulin injections. Patients carrying these mutations can produce insulin but have an insufficient insulin response to glucose. In addition to providing therapeutic benefits, oral glibenclamide treatment is more convenient than insulin injections, eliminates the pain due to injections, and provides greater flexibility, thereby allowing optimization of the dosage regimen and much better glycemic control. The better glycemic control is associated with improvements indyspraxia, supporting the early initiation of sulfonylureas (SU) therapy.Precision medicine in pediatrics requires suitable drug preparation allowing the administration of the lowest possible dosage that provides optimal glycemic control and neuropsychological improvements. Until recently, glibenclamide was available only as tablets, which had to be crushed and mixed with water for administration to neonates and infants. Even when prepared by hospital pharmacies, crushed tablets in water lack reliability as they have no microbiological stability and vary in concentration over time due to gradual sedimentation of the glibenclamide, which has limited solubility in water. AMMTeK has developed a paediatric glibenclamide (named glyburide in the US) oral suspension (AMGLIDIA®), which has been designated as an orphan drug for the treatment of NDM in europe and the US. Compared to crush tablets the suspension assures more consistent pharmacokinetics and could be more acceptable for children.

译文

新生儿糖尿病(ndm)的治疗方法与1型糖尿病相同,直到阐明疾病的遗传基础被证明涉及激活kcnj11或abcc81的突变。这一发现导致了糖尿病精确治疗的第一个例子,并导致了完全不同的、特殊的和成功的治疗方法,包括口服磺脲类药物(格列本脲,又称格列本脲),而不是注射胰岛素。携带这些突变的患者可以产生胰岛素,但对葡萄糖的胰岛素反应不足。除了提供治疗益处外,口服格列本脲治疗比胰岛素注射更方便,消除了注射带来的疼痛,并提供了更大的灵活性,从而可以优化剂量方案和更好的血糖控制。更好的血糖控制与改善胰岛素依赖有关,支持磺脲类药物(su)治疗的早期开始。儿科的精确医学需要合适的药物制剂,允许给药尽可能低的剂量,以提供最佳的血糖控制和神经心理改善。直到最近,格列本脲只能作为片剂使用,片剂必须压碎并与水混合,以便给新生儿和婴儿服用。即使由医院药房制备,压碎的片剂在水中也缺乏可靠性,因为它们没有微生物稳定性,并且由于格列本脲在水中溶解度有限而逐渐沉淀,浓度随时间而变化。AMMTEK开发了一种儿童格列本脲(在美国称为格列本脲)口服混悬液(AMGLIDIA®),该混悬液在欧洲和美国被指定为治疗ndm的孤儿药。与压碎片剂相比,该混悬剂保证了更一致的药代动力学,更适合儿童服用。