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1.
We observed an association between rotavirus diarrhoea and hypocalcaemia in several patients and therefore started a prospective
evaluation with measurement of calcium levels in all patients with rotavirus infection during a period of 8 months. We report
on 54 infants with rotavirus gastro-enteritis. Serum concentrations of sodium, potassium, and total and ionized calcium were
measured on admission. If hypocalcaemia was detected, total and ionized calcium were measured every day until recovery. Calcium
was supplemented as calcium gluconate which was added to milk. Out of 54 newborns with rotavirus gastro-enteritis, 20 developed
hypocalcaemia. All these newborns had severe diarrhoea. Seven infants were admitted because of convulsions, but EEG and ultrasonographic
examination of the brain revealed no abnormalities. Once the infants' clinical condition and the consistency and frequency
of the stool had improved, calcium concentrations increased and remained within the reference range without supplementation.
Conclusion Rotavirus gastro-enteritis seems to be a cause of neonatal hypocalcaemia.
Received: 26 June 1997 and in revised form: 20 December 1997 / Accepted: 26 December 1997 相似文献
2.
Hyperventilation often occurs under stressful conditions and has been reported before, during or after anaesthesia and surgery. Hyperventilation is characterised by multiple somatic symptoms due to hypocalcaemia induced by respiratory alkalosis because of inappropriate hyperventilation. It should be managed as an emergency. Here, we report a case of 30 year old full term parturient presenting in labour in a highly anxious state, presenting with symptoms and signs of hypocalcaemia in the form of circumoral numbness along with carpal spasm. The patient was managed successfully with reassurance and intravenous calcium gluconate. 相似文献
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康洋波周佳圻胡雨峰金禹辰杨琦沈嘉生许永安 《中华急诊医学杂志》2022,(5):603-607
目的探讨低钙血症在老年创伤性凝血病(trauma-induced coagulopathy,TIC)早期诊断中的预警价值。方法回顾性分析2015年1月至2020年9月浙江大学医学院附属第二医院急诊ICU中老年创伤患者临床资料,包括年龄、性别、损伤部位、创伤严重度评分(injury severity score,ISS)、格拉斯哥昏迷评分、入院24 h内首次动脉血气分析(Ca^(2+)、K^(+))、静脉血生化电解质(Ca^(2+)、K^(+)、Na^(+))、凝血谱[国际标准化比值、活化部分凝血活酶时间(activated partial thromboplastin time,APTT)、凝血酶原时间(prothrombin time,PT)、纤维蛋白原水平(fibrinogen,FIB)]、血制品使用、临床预后、ICU住院时间、总住院时间、总费用。采用多因素Logistic回归分析和ROC曲线评价血钙水平等相关风险因素在老年TIC早期诊断中效能。结果371例老年创伤患者年龄(72.5±6.8)岁,其中男性248例(66.8%)。TIC组ISS评分高于非TIC组[25(20,34)分vs.21(16,29)分];TIC组中胸部损伤、腹部损伤和四肢损伤发生率均高于非TIC组,而头颈部损伤发生率低于非TIC组;差异均具有统计学意义(均P<0.05)。TIC组静脉血生化血钙水平低于非TIC组[(1.97±0.19)mmol/L vs.(2.15±0.16)mmol/L,P<0.001],而动脉血气分析中钙离子水平差异无统计学意义。TIC组凝血谱中APTT值[(47.6±21.8)s vs.(33.8±4.1)s]、PT值[(18.0±3.9)s vs.(13.7±0.8)s]明显高于非TIC组,FIB值则明显低于非TIC组[(1.7±0.8)g/L vs.(2.8±0.9)g/L];差异均具有统计学意义(均P<0.01)。TIC组血制品使用率、总费用高于非TIC组,而预后好转率低于非TIC组(69.8%vs.86.4%,P<0.001)。多因素logistics回归分析显示低钙血症是老年创伤TIC的独立危险因素(OR=5.830,95%CI:3.295~10.314)。生化血钙与老年创伤TIC相关性的ROC曲线下面积为0.779(95%CI:0.728~0.831),最佳截断值为2.06 mmol/L。结论老年严重创伤早期生化血钙水平降低是发生TIC的独立危险因素。积极纠正老年TIC有助于不断改善临床预后。 相似文献
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目的 探讨p38丝裂原活化蛋白激酶(p38MAPK)信号转导通路对急性坏死性胰腺炎(ANP)大鼠低钙血症和甲状旁腺激素受体1(PTHR1)表达的影响.方法 将雄性SD大鼠72只按完全随机法分为ANP组、SB203580干预(SB)组和假手术(SO)组,每组分3、6、12 h 3个时间点,每个时间点8只.以5%牛磺脱氧胆酸钠逆行胰胆管注射建立ANP模型,SB组在造模前30 min腹腔注射p38MAPK特异抑制剂SB203580 10 mg/kg体重.观察各组血清钙浓度,蛋白质印迹法(Western blotting)分析骨组织磷酸化p38MAPK(P-p38 MAPK)和TNF-α变化,实时RT-PCR检测骨组织PTHR1 mRNA表达.结果 制模后6 h,SO组、ANP组和SB组血清钙浓度分别为(2.50±0.08)mmoL/L、(2.11±0.06)mmol/L和(2.35±0.10)mmol/L;骨组织P-p38 MAPK表达量分别为0.14±0.04、0.80±0.06和0.33±0.05;骨组织TNF-α表达量分别为0、0.91±0.04和0.44±0.03;骨组织PTHR1 mRNA表达量分别为1.00±0.12、0.23±0.04和0.44±0.06.SB组骨组织P-p38 MAPK及TNF-α表达较ANP组显著降低(P<0.01);骨组织PTHR1 mRNA表达量及血清钙浓度较ANP组显著增加(P<0.01).结论 p38MAPK信号转导通路可介导ANP低钙血症的发生,抑制该通路可改善ANP低钙血症. 相似文献
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Two cases of hypocalcaemia following removal of the stomach due to complications of surgery for tracheo-oesophageal anomalies are reported. In both instances grand mal seizures were the presenting features with radiological and biochemical evidence of rickets. Both children had elevated blood parathyroid hormone levels. The bone changes, hypocalcaemia and symptoms responded to parenteral vitamin D therapy. Sub total gastrectomy is a rare event in infancy and consequently no previous cases of vitamin D lack has been recorded as a complication of gastric surgery in this age group. 相似文献
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Hypocalcaemic tetany is a known complication of plasmapheresis. It has two causes. Intravenously administered 4.5% human albumin
solution (HAS) has no calcium or magnesium, so the replacement of plasma with this fluid depletes these ions. The citrate
in fresh frozen plasma (FFP) chelates divalent cations, so the exchange with this at the end reduces the proportion of calcium
and magnesium that is ionised. We studied the effect of supplementing HAS with 2 mmol/l calcium chloride and 0.8 mmol/l magnesium
sulphate on the changes in ionised and total calcium and magnesium concentrations throughout plasmapheresis. The supplements
prevented the falls in these concentrations that is otherwise seen during the HAS infusion, and, thus, the transient fall
in ionised calcium concentration induced by the citrate in the FFP was not so profound, reaching 0.92 instead of 0.78 mmol/l
(P = 0.002). Supplementation with calcium and magnesium during HAS maintains their balance and prevents tetany during the FFP
infusion. 相似文献
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