新生儿缺氧缺血性脑病血清钙测定与补钙方法探讨

目的：探讨新生儿缺氧缺血性脑病(HIE)伴低钙血症血钙水平及补钙的方法。方法：将伴有低钙血症的64例HIE患儿随机分为治疗组和对照组各32例，治疗组入院时补钙，对照组1周后补钙。在入院时、入院后第7天和第14天分别进行血游离钙测定。结果：18例轻度HIE血游离钙为(0.78±0.10) mmo1/L，30例中度为(0.72±0.13) mmo1/L，16例重度为(0.56±0.09) mmo1/L。轻、中度两组比较差异无显著性意义(P>0.05)，重度与轻、中度比较差异有显著性(t分别为 6.71，4.38，P<0.01)。两组患儿入院时和入院后第14天血游离钙水平差异无显著性(P>0.05)；但第7 d治疗组血游离钙水平明显高于对照组，差异有显著性意义(t＝6.28，P<0.01)。结论：HIE患儿伴血游离钙降低时常规予以补钙是安全的，入院时补钙和1周后补钙对病情转归无影响。

Determination of Serum Calcium and Calcium Supplement in Newborns with Hypoxic Ischemic Encephalopathy

OBJECTIVE: To study the level of serum calcium and the method of calcium supplement in newborns with hypoxic ischemic encephalopathy (HIE) accompanied by hypocalcemia. METHODS: Sixty four neonates with HIE accompanied by hypocalcemia were randomly assigned into the treatment group (n=32) and control group (n=32). The treatment group received calcium supplement immediately after hospitalization, and the control group at the second week after hospitalization. The serum calcium level was estimated in the two groups on admission, the seventh day and fourteenth day respectively.RESULTS: Serum free calcium levels were ( 0.78 ± 0.10 ), ( 0.72 ± 0.13 ) and ( 0.56 ± 0.09 ) mmo1/L, respectively, in the 18 cases with mild HIE, 30 cases with moderate HIE and 16 cases with severe HIE. There was no difference between the mild cases and the moderate cases, while significant difference was found between the severe cases and mild cases or the moderate cases (both P< 0.01 ). The serum free calcium level at admission and on the fourteenth day in the two groups was not different; but the serum free calcicum of the seventh day in the treatment group was obviously higher than that in the control group (P< 0.01 ). CONCLUSIONS: Supplementing calcium routinely was safe in HIE neonates with a lower serum free calcium level. The prognosis will not be influenced by the timing of calcium supplement.