新生儿缺氧缺血性脑病并低血钙时能否补钙问题的探讨  

STUDY ON THERAPY OF HYPOCALCEMIA IN CASES OF HYPOXIC ISCHEMIC ENCEPHALO PATHY OF NEWBORN

作　　者：黄润忠 李着算 冯泽康[2] 农绍汉[3] 周晓光[4] 邱芸芸 

机构地区：[1]广东顺德市妇幼保健院儿科 [2]广州暨南大学医学院附一院儿科,510632 [3]广东省人民医院新生儿科,510089 [4]广东省妇幼保健院新生儿科,150180 [5]广州市红十字会医院儿科,510224

出　　处：《新生儿科杂志》1999年第4期153-155,共3页The Journal of Neonatology

摘　　要：缺氧缺血性脑病新生儿 (NHIE)并低钙血症时补钙后是否会加重细胞内钙超载是临床上急待解决的问题 ,本研究测定了 NHIE的红细胞胞浆游离钙 (RBC[Ca2 + ]i)、红细胞总钙(RBC[Ca2 + ]T)及血浆总钙 (P[Ca2 + ]T)的动态变化 ,对 NHIE伴低钙血症者测定补钙前后RBC[Ca2 + ]i、RBC[Ca2 + ]T 及 P[Ca2 + ]T。结果 :NHIE生后第 1天 RBC[Ca2 + ]i 及 RBC[Ca2 + ]T明显升高 ,随病情好转 ,于生后第 3、5天降至正常。NHIE并低钙血症者补钙后 P[Ca2 + ]T 明显升高 ,随病情好转 ,于生后第 3.5天降至正常。 NHIE并低钙血症者补钙后 P[Ca2 + ]T 明显升高。而 RBC[Ca2 + ]i 及 RBC[Ca2 + ]T 却下降。提示 :1.NHIE生后第 1天存在细胞内钙超载 ,经复氧及治疗后钙超载减轻。 2 .对 NHIE并低血钙者 。In order to elucidate whether intracellular calcium is neonates of hypoxic ische mic encephalopathy (NHIE) complicated by hypocalcemia would be exacerbated if su pplemented with calcium, cytosolic free calcium concentration (RBC [Ca 2+ Ji]) and total calcium concentration (RBC[Ca 2+ ] T) in erythrocyte s and plasma calcium concentration (P[Ca 2+ ] T) in 15 cases of NHIE co mpli cated by hypocalcemia were measured before and after supplementation of calcium, and in 26 cases of NHIE with no complication of hypocalcemia and in 28 cases of normal term infants RBC[Ca 2+ ]i、 RBC[Ca 2+ ] T and P[Ca 2+ ] T were measured on the first, third and fifth days as contrals. Result s reveal that (1) RBC[Ca 2+ ]i and RBC[Ca 2+ ] T Were higher on the first day than those on the third and the fifth day after birth in the NHIE with no complication of hypocalcemia, (2) In the NHIE complicated by hypocalcem ia, P[Ca 2+ ] T inereased but RBC[Ca 2+ ]i. and RBC[Ca 2+ ] T didnt increase after supplementation of calcinm. The study indicates :1 there was intracellular calcium overload in the NHIE on the first day after birth and the calciam overload returned to normal standard as the disorder of HI E improved; 2.therapy of intravenous infusion of 10% calcium gluconate to neonat es with hypoxic ischemic encephalopathy complicated by hypocalcemia would elevat e the plasma calcium concentration and at the same time it did not deteriorate t he intracellular calcium overload (Original article on page 封 三)

关 键 词：缺氧缺血性脑病 新生儿 低钙血症 补钙 

分 类 号：R591.105[医药卫生—内科学] R722.120.6[医药卫生—临床医学]