宫内生长迟缓新生儿的骨钙素、25-OHD3及钙磷镁代谢的研究

目的]探讨宫内生长迟缓（intrauterine growth retardation,IUGR）新生儿是否存在钙磷代谢异常并探讨其临床意义.方法]分为两组：IUGR儿（即小于胎龄儿,small for gestational age,SGA）组24例,适于胎龄儿（appropriate gestational age,AGA）组30例.采用酶联免疫分析法测定新生儿脐血中骨钙素（osteocalcin,OC）及25-OHD3浓度;采用全自动生化仪测定新生儿脐血钙、磷、镁的浓度.结果]与AGA组相比,IUGR组脐血中骨钙素及血磷水平显著降低（分别为t=4.60,P＜0.01;t=3.80,P＜0.001）;骨钙素与出生体重呈正相关（r=0.558,P＜0.001）;IUGR组脐血钙及25-OHD3两组相比,差异无显著性（t=1.125,P＞0.05;t′=1.112,P＞0.05）.结论]IUGR新生儿生后早期钙、磷、镁代谢存在异常.

Study of changes on serum osteocalcin and 25-dihydroxyvitamine D3 and calcium, phosphorus and magnesium in cord blood of the newborns with intrauterine growth retardation

Objective] To research for whether the metabolism of calcium and phosphorus in intrauterine growth retardation (IUGR) newborns was abnormal, and research for the clinic use. Methods] The cases were divided into two groups:intrauterine growth retardation, group (n= 24)and appropriate gestational age(AGA) group (m=30). The serum OC and 25-OHD3 were were measured by Enzyme-Linked Immunosorbent Assag(ELISA). The calcium, phosphorus and magnesium were measured by auto-biochemistry analysis machine. Comparisons between two groups were used by student' s T test. The relationship between the levels of OC, phosphorus and magnesium to birth weight and gestational age were assessed by regression analysis. Results] The concentrations of OC and phosphorus in IUGR group were significantly lower than in AGA group (t = 4. 60,P<0. 01);t =3. 80,P<0. 001). The levels of OC correlated positively to the birth weight (r=0. 558,P<0. 001). The levels of OC didn't correlate to the gestational age(r=0. 079, P>0. 05). The levels of phosphorus didn't correlated to the birth weight and the gestational age(r=0. 083,P>0. 05;r=0. 117, P>0. 05). The concentrations of calcium and 25-dihydroxyvitamin D3 were not different between the two groups (t=1.125, P>0. 05;t' = 1. 112,P>0. 05). The concentration of magnesium was significantly higher in IUGR group than in AGA group (t = 2. 83,P <0. 05). The levels of magnesium correlated negatively to the birth weight(r=-0. 483,P<0. 001) , and did not correlate to the gestational age(r=0. 056,P>0. 05). Conclusion] The results suggested that the metabolism of calcium and phosphorus should be abnormal in IUGR newborns.