新生儿低钙血症危险因素分析

Analysis of risk factors of neonatal hypocalcem

目的分析新生儿低钙血症发病的危险因素,以期为临床诊疗提供理论依据。方法将162例临床资料完整的患儿纳入研究,根据测定的血钙值将其分为低钙血症组(n=74)和非低钙血症组(n=88),以低钙血症是否发生为因变量,可能的影响因素为自变量,建立Logistic回归模型,采用SPSS17.0软件,进行非条件Logistic回归分析。结果多因素非条件Logistic回归分析显示,孕周、出生体重、新生儿窒息、新生儿及母孕期维生素D缺乏和母孕期糖尿病与低血钙发生显著相关(P<0.05),且提示孕周越小、出生体重越低、窒息发生、新生儿及母孕期维生素D缺乏和母孕期合并糖尿病的新生儿,出现低钙血症的危险性越大。29例出现肢体抽搐的患儿行振幅整合脑电图(aEEG)检查,其中aEEG异常的22例患儿低血钙纠正后复查aEEG均正常。结论新生儿低钙血症的发病与患儿孕周、出生体重、新生儿窒息、新生儿及母孕期维生素D缺乏和母孕期糖尿病有密切的相关性。而且,短暂的新生儿低血钙可引起暂时的aEEG异常。

Objective To investigate the impact of risk factors for neonatal hypocalcem and to provide theoretical basis for clinical practice. Methods One hundred and sixty-two infants were enrolled as subjects.Blood samples shared with biochemical analyzer to check serum total calcium.The groups were divided into two groups：hypocalcemia（n=74）and nonhypocalcemia（n=88）.In the incidence of hypocalcem as the dependent variable,the influencing factors as independent variables to establish Logistic regression model.The non conditional Logistic regression analysis conducted with SPSS17.0software. Results In the multiple Logistic regression analysis,gestational age,birth weight,asphyxia,low serum vitamin D concentration in newborns,vitamin D deficiency and diabetes during pregnancy were independently associated with hypocalcem（P〈0.05）,prompted the lighter birth weight,the smaller the gestational age,low serum vitamin D concentration in newborns,asphyxia occurred and vitamin D deficiency and diabetes during pregnancy appeared higher risk of neonatal hypocalcemia greater.Among the 29 neonates who underwent amplitude-integrated EEG（aEEG）,22 had abnormalities,which normalized after calcium returned to normal. Conclusions The gestational age,birth weight,asphyxia,low serum vitamin D concentration in newborns,vitamin D deficiency and diabetes during pregnancy are risk factors for hypocalemia.Moreover,transient neonatal hypocalcimia can cause transient aEEG abnormalities.