影响新生儿骨碱性磷酸酶水平的相关因素分析

The Correlative Factors Analysis on Influencing Bone Alkaline Phosphatase Levels in Newborn

目的研究影响新生儿骨碱性磷酸酶(Bone Alkaline Phosphatase BALP)水平的相关因素。方法采用免疫渗滤和全血干化学技术原理对164例新生儿进行骨碱性磷酸酶水平测定。对胎龄、产重、性别、出生季节、窒息、分娩方式、新生儿血清钙、母亲孕期居住地、母孕期间贫血、孕期保健情况、母孕期间有无抽筋表现、母孕期间补钙情况等12个拟定因素作统一量化编码,应用PEMS 3.1医学统计软件,经过单因素相关分析,筛选出有显著意义的因素进一步作多元逐步回归(前进法)统计分析。结果受检的164例中BALP≤200 U/L24例,200-250 U/L84例,250-300 U/L 54例,≥300 U/L 2例。单因素资料统计分析结果显示胎龄(t′=3.3355,t′a=2.0099,p<0.05)、产重(r=-0.2805,p=0.0003)、出生季节(H=15.8038,p=0.0009)、新生儿血清钙(r=-0.2504,p=0.0012)、母孕期间补钙(t′=2.4845,t′a=1.9918,p<0.05)和孕期保健(t′=2.6428,t′a=1.9929,p<0.05)6个因素对BALP水平有明显影响。进一步多元逐步回归统计分析结果显示产重(X2)、新生儿血清钙(X7)2个因素被纳入方程;回归方程为:Y=331.6359-14.4058 X2(产重)-19.8212 X7(血清钙),经方差分析(F=9.6747,p=0.0001),回归方程有统计学意义;从偏回归系数的检验知χ2的回归系数(t=2.8362,p=0.0052)和X7的回归系数(t=2.2720,p=0.0244)均有统计学意义。结论新生儿骨碱性磷酸酶的活性水平与新生儿产重、新生儿血清钙呈明显负相关,预防新生儿骨代谢异常应从孕期保健抓起。

Objective To investigate the correlative factors of influencing Bone alkaline phosphatase （ BALP ） levels in newborn . Methods Adopting the principle of immunoeoncentration and whole blood dry chemistry to measure the catalytic activity of BALP in 164 newborn . Make to unify quantity to turn coding towards drafting factors ,and work out the single factor related analysis through PEMS 3.1 medical statistical software processing, then use the multiple stepwise regression to analyze the selected factors data further. Results In 164 cases, BALP ≤200U/L 24 cases （ normal ） ,200-250U/L 84 cases,250- 300U/L 54 cases,≥300 U/L 2 cases. Statistical analysis of single factor data showed that the gestational age （ t′ = 3. 3355, t′a = 2. 0099 ,p 〈 0.05 ） ,birth weight （ r = - 0. 2805 ,p = 0. 0003 ） , birth season （ H = 15. 8038 ,p = 0. 0009 ） ,serum calcium of newborn （ r = - 0. 2504 ,p = 0. 0012 ） ,repairing calcium in pregnant period（ t′ = 2.4845 ,t′a = 1. 9918 ,p 〈 0.05 ） and antenatal care（ t′ = 2. 6428, t′a = 1. 9929 ,p 〈 0.05 ） were related significantly with the changing of BALP levels. Multiple stepwise regression analysis showed that birth weight and serum calcium of newborn were checked ;analysis of variance showed regression equation [ Y = 331. 6359 - 14. 4058 X2 （ birth weight） - 19. 8212 X7 （ serum calcium） ] was significant （ F = 9. 6747 ,p = 0. 0001 ） ; t - test results displayed that both regression coefficient （ t = 2. 8362 ,p = 0. 0052 ） of birth weight and regression coefficient（ t = 2.2720 ,p = 0. 0244）of serum calcium were with statistical significance. Conclusion The variety of BALP levels with birth weight,serum calcium have obviously negative correlation. Preventing newborn from the abnormality of bone metabolism should be started to grasp from antenatal care .