新生儿血钙水平与围生期因素的关系及与智能尿检系统检测的尿钙水平的关系

目的 研究新生儿血钙水平与围生期因素的关系，以及与智能尿检系统所检测尿钙水平的关系。方法 采用横断面调查法收集2018年6~8月于西安交通大学第一附属医院新生儿科住院的96例轻症足月单胎新生儿的临床资料，记录智能尿检系统检测的新生儿尿钙含量和同期血总钙、离子钙水平，以及母亲孕期钙剂及维生素D的补充情况。结果 母亲孕期补充维生素D组（n=79）新生儿血总钙及离子钙水平均高于未补充维生素D组（n=17）（P < 0.05）。母亲孕期同时补钙及维生素D组（n=68）新生儿离子钙水平高于非同时补充组（n=28）（P=0.05）。母亲孕期补钙组（n=74）与未补钙组（n=22）比较，新生儿血总钙及离子钙水平差异均无统计学意义（P > 0.05）。低体温组新生儿（n=5）血总钙水平低于正常体温新生儿（n=91）（P < 0.05）。母亲血总钙水平与新生儿血总钙和离子钙水平均呈显著正相关（分别r=0.881、0.703，P < 0.05）。智能尿检系统检测的新生儿尿钙水平与血离子钙水平呈显著正相关（r=0.526，P=0.025）。结论 母亲孕期补充维生素D可增加新生儿血总钙及离子钙水平，而单纯补充钙剂可能不能增加新生儿血总钙及离子钙水平。新生儿低体温可能会造成血钙降低。智能尿检系统检测的新生儿尿钙水平与血离子钙水平呈正相关。

Association of neonatal blood calcium levels with perinatal factors and neonatal urinary calcium levels measured by an intelligent urine test system

Objective To study the association of neonatal blood calcium levels with perinatal factors and neonatal urinary calcium levels measured by an intelligent urine test system. Methods The medical data of 96 full-term singleton neonates with mild diseases were collected by a cross-sectional survey, who were hospitalized in the Department of Neonatology, The First Affiliated Hospital of Xi'an Jiaotong University, from June to August 2018. Urinary calcium levels measured by an intelligent urine test system, total blood calcium levels, ionized calcium levels, and the mother's calcium and vitamin D supplementation during pregnancy were recorded. Results Compared with the group without vitamin D supplementation for the mother (17 neonates), the group with vitamin D supplementation for the mother (79 neonates) had significantly higher levels of total blood calcium and ionized calcium (P < 0.05).The group with both vitamin D and calcium supplementation for the mother (68 neonates) had significantly higher levels of ionized calcium than controls (28 neonate) (P=0.05). There was no significant difference in the levels of total blood calcium and ionized calcium between the group with calcium supplementation for the mother (74 neonates) and the group without calcium supplementation for the mother (22 neonates) (P > 0.05). The hypothermia group (5 neonates) had a significantly lower level of total blood calcium than the normal body temperature group (91 neonates) (P < 0.05). There was a significantly positive correlation between the maternal blood total calcium level and the neonatal blood total calcium and ionized calcium levels (r=0.881 and 0.703 respectively; P < 0.05). The neonatal urinary calcium level measured by the intelligent urine test system was significantly correlated with the blood ionized calcium level (r=0.526, P=0.025). Conclusions Vitamin D supplementation during pregnancy can increase the blood levels of total calcium and ionized calcium in neonates, and calcium supplementation alone cannot increase the blood levels of total calcium or ionized calcium in neonates. Hypothermia in neonates might cause the reduction in blood calcium levels. The urinary calcium level measured by the intelligent urine test system is positively correlated with the blood level of ionized calcium.