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研究新生儿缺氧缺血性脑病(HIE)的甲状旁腺素(PTH)、降钙素(CT)及血钙水平变化,为临床治疗HIE提供参考依据。应用放射免疫法对59例足月HIE患儿(轻度组18例,中度组21例,重度组20例),于急性期及恢复期各测定一次血清PTH、CT及钙水平,并以20例正常足月新生儿作为对照组。结果显示:轻、中、重度HIE组患儿急性期血钙水平分别为2.23±0.21、2.06±0.23、1.88±0.25,均低于对照组2.39±0.28(P值分别为<0.05、0.001、0.001),且临床分度愈重,血钙下降愈明显,HIE各组间差异显著;中、重度HIE组PTH水平分别为210.356±56.142、201.461±62.763;CT水平分别为115.879±36.469、124.765±48.571,较对照组及轻度HIE组PTH降低、CT升高(P<0.05)。HIE各组患儿恢复期血钙复升,中、重度HIE组PTH复升、CT下降,与急性期比较有显著差异(P<0.05),但重度HIE组恢复缓慢。结论:HIE时PTH下降、CT升高与血钙降低有关,在治疗HIE患儿时应严密监测血钙,应用钙剂应掌握适应症和剂量,极为重要。
To study the changes of parathyroid hormone (PTH), calcitonin (CT) and serum calcium levels in neonates with hypoxic-ischemic encephalopathy (HIE), so as to provide a reference for the clinical treatment of HIE. Fifty-nine full-term HIE infants (18 in mild group, 21 in moderate group, and 20 in severe group) were measured by radioimmunoassay. Serum levels of PTH, CT and calcium were measured in acute and convalescent patients respectively. Twenty normal full-term newborns served as control group. The results showed that the levels of serum calcium in acute, moderate and severe HIE patients were 2.23 ± 0.21, 2.06 ± 0.23 and 1.88 ± 0.25 respectively, both lower than that of the control group (2.39 ± 0.28, P <0.05,0.001 and 0.001 respectively ), And the more serious the clinical sub-grade, the more obvious decline in serum calcium, HIE significant differences between the various groups; moderate and severe HIE group PTH levels were 210.356 ± 56.142,201.461 ± 62.763; CT levels were 115.879 ± 36.469,124.765 ± 48.571 , PTH was lower and CT was higher in the control group and mild HIE group (P <0.05). The levels of serum calcium in convalescent HIE group were significantly higher than those in acute HIE group (P <0.05). However, severe HIE group recovered slowly. Conclusions: PTH decline in HIE and elevated CT are associated with decreased serum calcium. Serum calcium should be closely monitored during treatment of children with HIE. Application of calcium should be appropriate for indications and doses and is of paramount importance.