缺氧缺血性脑病新生儿甲状旁腺素与血钙检测的临床意义

Clinical significance of parathyroid hormone and calcium levels in hypoxic ischemic encephalopathy neonates

目的研究缺氧缺血性脑病(HIE)新生儿甲状旁腺素(PTH)及血钙水平变化,为临床治疗HIE提供参考依据。方法应用放射免疫法对43例足月HIE患儿(轻度组25例,中重度组18例),于生后24 h、72 h及生后7 d各测定1次血清PTH及钙水平,并以40例正常足月新生儿作为对照组。结果 HIE组患儿生后24 h血钙水平均低于对照组(P均<0.05),且临床分度愈重,血钙下降愈明显;生后24 h中重度HIE组PTH水平高于对照组及轻度HIE组(P均<0.05);生后72 h中重度HIE组患儿血钙水平低于对照组和轻度HIE组(P均<0.05);生后72 h轻、中重度HIE组患儿PTH水平均高于对照组(P均<0.05),且临床分度愈重,PTH升高愈明显;生后7 d 3组间血钙水平无显著性差异,但对照组高于轻、中重度HIE组患儿;生后7 d对照组PTH水平低于轻度和中重度HIE组(P均<0.05)。结论 HIE新生儿血PTH水平较正常新生儿升高,其血浓度升高与HIE严重程度成正比,与血钙的变化存在相关性。

Objective It is to study the changes of parathyroid hormone （PTH） and serum calcium level of neonates with hypoxic ischemic encephalopathy （HIE） , and to provide reference for treating this disease in clinic. Methods Serum PTH and calcium in 43 full-term neonates with HIE （25 cases in mild group, 18 cases in severe group） were determined by radioimmu-noassay at 24 hours, 72 hours and 7 days after birth, and the indexes above in 40 normal full-term newborns were as a control group. Results The level of serum calcium in HIE group at 24 h after birth were lower than that in the control group （ P 〈 0.05 ）, and the more severe clinical grading, the more decrease of blood calcium level; at 24 h after birth, the levels of PTH in moderate and severe HIE group were higher than that of the mild HIE group and control group （ P 〈 0.05 ） ; at 72 h afterbirth, then levels of calcium in moderate and severe HIE group were lower than that of the control group and mild HIE group; at 72 h after birth the levels of PTH in light, moderate and severe HIE group were higher than that in control group, and the more severe clinical grading, the more increase of PTH ; at 7 d after birth, there was no significant difference in serum calcium levels among the three groups（P 〉 0.05） , but that in the control group was higher than that in light and moderate and severe HIE group; at 7 d after birth the level of PTH in control group was lower than that in HIE group（ P 〈 0.05 ）. Conclusion Serum PTH level is higher in HIE neonates than that in normal ones, and its increase has a direct proportion to the severity of HIE, and it is also correlated with calcium changes.