窒息新生儿血清钙、镁变化的临床意义

Clinical Significance of Serum Calcium and Magnesium in the Newborn with Asphyxia

目的回顾性分析窒息新生儿血清钙、镁的动态变化及相互关系。方法选择窒息新生儿87例为研究组,其中29例单纯轻度窒息患儿为Ⅰ组、21例单纯重度窒息患儿为Ⅱ组、37例窒息合并缺氧缺血性脑病(HIE)患儿为Ⅲ组。随机选择正常新生儿30例为对照组。均在出生第1、3、7天进行血清钙、镁测定。结果低钙、低镁血症总发生率比较,研究组分别为56.32%、45.98%,明显高于对照组的16.67%、10.00%(P<0.01);Ⅰ、Ⅱ、Ⅲ组明显高于对照组(P<0.05),且Ⅱ组高于Ⅰ组、Ⅲ组高于Ⅱ组(P<0.05)。Ⅰ、Ⅱ、Ⅲ组患儿血清钙、镁水平持续降低并在第3天最明显,与第1天相比有显著性差异(P<0.05),与对照组比较明显降低(P<0.05),且Ⅱ组低于Ⅰ组、Ⅲ组低于Ⅱ组(P<0.05)。低镁血症患儿有87.63%(35/40)伴有低钙血症。结论应动态检测窒息新生儿的血清钙、镁,并作为判断病情和预后的一个指标。低镁血症患儿补镁的同时注意适量补钙。

Objective To explore dynamic levels of serum calcium and magnesium and their relation in the newborn with asphyxia. Methods A total of 87 cases of neonate asphyxia were retrospectively investigated,of which 29 cases were simple lower ones （group Ⅰ ） ,21 cases were simple higher ones （group Ⅱ ） ,and 37 cases of asphyxia combined with hypoxic-ischemic encephalopathy （group Ⅲ ）. 30 other healthy neonates were randomly selected served as normal control group. The levels of calcium and magnesium were detected on the 1st, 3rd, 7th day after birth in all groups. Results The total incidence of hypocalcemia and hypomagnesemia of 87 asphyxia cases were respectively 56. 32% and 45. 98%, which were significantly higher than 16. 67% and 10.00% in control group（P〈0. 01）. Again in respect of hypocalcemia and hypomagnesemia, group Ⅰ , Ⅱ ,and Ⅲ exhibited higher than control group （P〈0. 05）, groupⅡ higher than group Ⅰ （P〈0. 05）, and group Ⅲ higher than group Ⅱ （P〈0. 05）. The levels of serum calcium and magnesium in group Ⅰ , Ⅱ , and Ⅲ persistently declined, which reached their lowest on the third day and were significantly lower than those on the first day and in the normal group （P〈0.05）, moreover,group Ⅱ were lower than group Ⅰ （P〈0. 05） ,group Ⅲ were lower than group Ⅱ （P〈 0.05）. 87. 63% （35/40） of the patients with hypomagnesemia also contracted hypocalcemia. Conclusion The levels of serum calcium and magnesium in the newborn with asphyxia should be dynamically monitored,and should be used as the indications for judgement of pathogenetic condition and prognosis. It is essential and effective to supply calcium when magnesium is supplyed in asphyxia neonates with hypomagnesemia.