新生儿骨矿代谢临床研究

目的 了解不同分类新生儿的骨矿代谢状况,并对比各项骨矿代谢指标在骨营养代谢异常中的诊断价值,为早期干预提供依据。方法 选取90例新生儿,其中足月儿62例、早产儿28例(极低出生体重儿12例,低出生体重儿16例)作为研究对象。检测血清骨钙素(OC)、β胶原分解片段(β-CTx)、血清钙(Ca²⁺)、25-羟胆骨化醇[25-(OH)D₃]及甲状旁腺素(PTH)浓度,并采用两组独立样本t检验及Pearson相关分析对检测结果进行统计学分析。结果 早产儿组血清β-CTx浓度高于足月儿组(P<0.05),血清Ca²⁺和PTH浓度低于足月儿组(P分别<0.01和<0.05);早产儿组血清OC水平与Ca²⁺、25-(OH)D₃呈正相关,血清β-CTx水平与Ca²⁺和25-(OH)D₃呈负相关;极低出生体重(VLBW)组血清OC与Ca²⁺浓度低于低出生体重(LBW)组(P均<0.05),血清β-CTx浓度高于LBW组(P<0.05); VLBW组血清OC水平与Ca²⁺、25-(OH)D₃呈正相关,血清β-CTx水平与Ca²⁺、25-(OH)D₃呈负相关;新生儿血清OC、Ca²⁺水平与胎龄、体重正相关,血清β-CTx水平与胎龄、体重负相关。结论 新生儿血清骨矿代谢指标水平主要受胎龄、体重因素的影响,早产儿易出现骨营养代谢异常,且胎龄越小(体重越轻)越易出现骨营养代谢异常,临床上应尽早发现并及时合理补充VitD和钙。

Clinical research on bone and mineral metabolism in neonates

Objective To explore bone and mineral metabolism in different neonates,and compare the diagonostic value of bone and mineral metabolism markers in bone metabolism abnormality,and provide basis for early intervention. Method The concentrations of serum osteocalcin (OC),beta-crossLaps (β-CTx),calcium,25-hydroxycholecalciferol[25-(OH)D₃]and parathyroid hormone (PTH) were measured in 62 full-term infants,28 preterm infants(12 very low birth weight,16 extremely very low birth weight),and the data were statistically analyzed. Results The concentration of serum β-CTx in group of preterm infants was higher than that in group of full-term infants(P<0.05),and the concentration of serum calcium and PTH were less than those in full-term infants(P<0.01 and <0.05);Level of serum OC in preterm infants had positive correlations with serum calcium and 25-(OH)D₃,and level of serum β-CTx had negative correlations with serum calcium and 25-(OH)D₃;The concentrations of serum OC and calcium in group of very low birth weight infants were less than those in low birth weight infants(P<0.05),and the concentrations of serum β-CTx were higher than that in low birth weight infants(P<0.05);Level of serum OC in very low birth weight infants had positive correlations with serum calcium and 25-(OH)D₃,and level of serum β-CTx had negative correlations with serum calcium and 25-(OH)D₃;Levels of serum OC and calcium in neonates had positive correlations with gestational age and birth weight,and level of serum β-CTx had negative correlations with gestational age and birth weight. Conclusions The main factors which affect levels of bone and mineral markers in neonates are geatational age and birth weight,preterm infants easily occur bone metabolism abnormality,and the less gestational age (the less birth weight),the more easily occur bone metabolism abnormality,we need pay attention to find bone metabolism abnormality early and supple vitamin D and calcium.