足月新生儿低钙血症合并甲状旁腺功能减退症的高危因素分析

Analysis of High-risk Factors of Hypocalcemia in Term Neonates with Hypoparathyroidism

目的:探讨足月新生儿低钙血症合并甲状旁腺功能减退症的高危因素,为该病的防治提供依据。方法:选取2012年2月1日-2019年2月1日在福建省妇幼保健院住院的82例低钙血症足月新生儿为研究对象,以确诊足月新生儿甲状旁腺功能减退症的41例足月新生儿作为病例组,选择同期入院的41例非甲状旁腺功能减退所致低钙血症足月新生儿作为对照组。比较两组孕母产科情况、分娩情况、新生儿一般情况及疾病发生和治疗情况的差异。采用t检验、X^2检验及Logistic回归模型分析足月新生儿甲状腺旁腺功能减退症的高危因素。结果:病例组患儿母亲妊娠期糖尿病占比、母亲孕期使用胰岛素占比、胎盘异常发生率、患儿使用镇静剂占比、使用利尿剂占比、使用碱性液占比、脓毒症发生率、酸中毒发生率、合并呼吸衰竭占比、合并先天性心脏病占比均高于对照组,差异均有统计学意义(P<0.05)。Logistic多元回归分析表明,脓毒症、代谢酸中毒为足月新生儿甲状旁腺功能减退的主要危险因素(P<0.05)。结论:脓毒症、代谢性酸中毒的足月儿低钙血症合并甲状旁腺功能减退症风险较高。

Objective:To explore the high risk factors of hypocalcemia with hypoparathyroidism in term neonates,and to provide the basis for the prevention and treatment of this disease.Method:A total of 82 full-term newborns with hypocalcemia treated at Fujian Provincial Maternity and Child Care Hospital between 1st Feb,2012 and 1st Feb,2019 were selected as the objects of the study.The 41 cases of full-term newborns diagnosed as full-term newborns hypoparathyroidism were taken as medical case group,hypocalcemia full-term newborns not caused by hypoparathyroidism and hospitalized during the same period were selected as the control group by 1:1 ratio.The between-group differences of maternity obstetrical conditions,delivery conditions,general conditions of new-born,the onset of diseases and treatment conditions were compared.t-test,chi-square test and Logistic regression model were utilized to analyze the high risk factors of hypoparathyroidism in full-term new-born.Result:The proportion of gestational diabetes mellitus,proportion of insulin used during pregnancy,incidence of abnormal placenta,proportion of children using sedatives,proportion of diuretics,proportion of alkaline solution,incidence of sepsis,incidence of acidosis,proportion of combined respiratory failure,proportion of combined congenital heart disease in the medical case group were higher than those in the control group,the differences were statistically significant (P<0.05).The multivariate Logistic regression analysis indicated that sepsis,metabolic acidosis were the major risk factors of hypoparathyroidism (P<0.05).Conclusion:The full-term new-born with sepsis and metabolic acidosis have a higher risk of suffering from hypoparathyroidism.