新生儿低钙血症高危因素的探讨

The Investigation of Risk Factors for Neonatal Hypocalcemia

目的探讨影响早期新生儿血钙的高危因素。方法选择正常新生儿50例为对照组,住院新生儿476例,分别于生后24h、3d、5d、7d抽取股静脉血,用日本产全自动生化分析仪查血清总钙和游离钙、血清钠、血糖、心肌酶。用U检验分析实验组与对照组低钙发生率的差异;用多因素回归分析分析性别、孕周、出生体重、颅内出血、窒息或宫内窘迫、肌酸磷酸激酶(CPK)、组织损伤、低血钠、低血糖对血钙的影响。统计学方法:采用SPSS 13.0软件包,Logistic回归分析。结果实验组低钙发生率为26.05%(124/476),对照组低钙发生率为0,U=4.11,P<0.01。Logistic回归分析结果:出生体重、血糖、孕周、窒息、及CPK入选方程,B分别0.074,-0.492,-0.040,0.600,0.001,EXP(B):0.485,0.612,0.961,1.822,1.001。P<0.05,提示出生体重越轻、血糖越低、孕周越小、窒息发生及CPK越高出现新生儿低钙的危险性越大。结论病理儿易出现低钙,低出生体重、低血糖、早产、窒息、CPK增高为低钙的高危因素。性别、组织损伤、颅内出血、低钠与低钙无关。

Objective To investigate the impact of risk factors for neonatal hypocalcemia.Methods 50 cases of normal neonates as a control group,476 cases of hospitalized neonates,respectively,in 24 hours after birth,3 days,5 days, 7 days,blood samples shares with Japan automatic biochemical analyzer check serum total calcium free calcium and serum sodium,glucese,enzymes.U test analysis with the experimental group and control group differences in the incidence of hypoealeemia;using multi-factor regression analysis,gender, gestational age, birth weight,intracranial hemorrhage,asphyxia or fetal distress,hypoxia--induced myocardial damage,tissue damage,tow-- sodium low blood sugar on the effects of calcium.Statistical Methods SPSS13.0 package, Logistic regression analysis. Results The incidence rate of hypocalcemia 26.05%（124/476）,1ow calcium control group incidence of 0,U=4.11,P〈0.01.Logistic regression analysis：birth weight, blood glucose, gestational age, asphyxia, and CPK selected equation,B respectively, -0. 074,--0. 492,--0. 040,0. 600,0.001, EXP （B） ： 0. 485,0.612,0. 961,1. 882,1. 001. P〈0.05, prompted the lighter birth weight,lower blood sugar,the smaller the gestational age, asphyxia occurred and CPK appeared higher risk of neonatal hypocalcemia greater.Conclusion The pathological infants prone to low calcium, low birth weight, hypoglycemia, prematurity, asphyxia, CPK increased risk factors for hypoealcemia. Sex, tissue injury,intracranial hemorrhage, hyponatremia has nothing to do with calcium.