2021 年第 1 期 第 16 卷

早产儿早期血清甲状旁腺激素水平对低钙血症的预测价值

Predictive value of early serum parathyroid hormone level in premature infants with hypocalcemia

作者：郑有宁王鑫王婵康天程亚颖

英文作者：Zheng Youning Wang Xin Wang Chan Kang Tian Cheng Yaying

单位：河北省人民医院儿科，石家庄050000

英文单位：Department of Pediatrics Hebei General Hospital Shijiazhuang 050000 China

关键词：低钙血症；早产儿；甲状旁腺激素

英文关键词：Hypocalcemia;Prematureinfants;Parathyroidhormone

• 摘要：

• 目的 研究早产儿早期血清甲状旁腺激素(PTH)水平对低钙血症的预测价值。方法选择2017年1月至2019年12月于河北省人民医院出生的200例早产儿作为观察组，选择同时期本院出生的200例足月儿作为对照组。2组新生儿于出生后0、12、24、48 h分别行血清PTH水平检测，出生后0～7 d逐日行血钙水平检测。观察组根据是否出现低钙血症分为低钙血症亚组和非低钙血症亚组，比较2亚组基本临床资料及PTH水平，分析早产儿发生低钙血症的危险因素。结果 观察组新生儿出生后0、12、24 h血清PTH水平均明显低于同时点对照组［（25±12）ng/L比（29±13）ng/L、（25±12）ng/L比（30±12）ng/L、（28±13）ng/L比（32±13）ng/L］（均P＜0.05），出生后2～5 d血清总钙水平均明显低于同时点对照组（均P＜0.05）。观察组低钙血症发生率明显高于对照组［47.5%(95/200)比3.0%(6/200)，P＜0.001］。低钙血症亚组体质量、胎龄和出生后0、12、24 h血清PTH水平均明显低于非低钙血症亚组（均P＜0.05）。Logistic多因素回归分析结果显示，胎龄、体质量、PTH均为早产儿发生低钙血症的独立危险因素（均P＜0.05）。以出生12 h血清PTH对早产儿低钙血症的诊断价值最佳，曲线下面积为0.881(95%置信区间：0.817～0.948)。结论 通过对早产儿出生后24 h内血清PTH水平进行检测，可预测低钙血症的发生。

• Objective To investigate the predictive value of early serum parathyroid hormone (PTH) level in premature infants with hypocalcemia. Methods Totally 200 premature infants born in Hebei Provincial People′s Hospital from January 2017 to December 2019 were selected as the observation group, and 200 full-term infants born in our hospital during the same period were selected as the control group. General clinical data of the two groups were collected, and serum PTH level of the two groups was detected at 0, 12, 24 and 48 h after birth, and serum calcium level of the two groups was detected at 0-7 d after birth. The observation group was divided into hypocalcemia subgroup and non-hypocalcemia subgroup according to the presence or absence of hypocalcemia. The basic clinical data and PTH level were compared between the two subgroups. Results At 0, 12 and 24 h after birth, PTH levels in the observation group were significantly lower than those in the control group［（25±12）ng/L vs （29±13）ng/L,（25±12）ng/L vs （30±12）ng/L,（28±13）ng/L vs （32±13）ng/L］(all P＜0.05). On the 2-5 d after birth, the total serum calcium levels in the observation group were significantly lower than those in the control group (all P＜0.05). The incidence of hypocalcemia in the observation group was significantly higher than that in the control group［47.5%(95/200) vs 3.0%(6/200)，P＜0.001］. Body weight, gestational age, PTH level at 0, 12 and 24 h after birth in hypocalcemia subgroup  were significantly lower than those in non-hypocalcemia subgroup (all P＜0.05). Multivariate Logistic regression analysis showed that gestational age, body weight and PTH were independent risk factors in premature infants with hypocalcemia（all P＜0.05）. The value of serum PTH at 12 h of birth was the best for the diagnosis of premature infants with hypocalcemia, and the area under the curve was 0.881 (95% confidence interval: 0.817-0.948). Conclusion The occurrence of hypocalcemia can be predicted by detecting the PTH level of preterm infants within 24 h after birth.