Calcium Homeostasis Studies in Early Hypocalcemic Premature

早發型低血鈣症早產兒的血鈣調節之研究

林清淵(Ching-Yuang Lin) ； 石田允(Makoto Ishida)

《Acta Paediatrica Sinica》 26卷1期 (1985/02) Pp. 1-7

摘要

以21位患者兒低血鈣症之早產兒及10位正常新生兒作為對照組，測其血清中Calcitonin, 副甲狀腺素、血漿中1α，25-雙羥（維生素）D3 25-單羥（維生素）D3之濃度及Ellsworth-Howard試驗，結果發現：低血鈣症之新生兒其腎小管細胞對副甲狀腺素呈低反應狀態，及高血Calcitonin濃度、低血漿1α，25-雙經（維生素）D3, 25-單羥（維生素）D3濃度，而血清中副甲狀腺素及鎂濃度均正常。21位早產兒中10位同時測其母親血中鈣、磷、Calcitonin、副甲狀腺素，及血漿中1α，25-雙羥（維生素）D3, 25-單徑（維生素）D^3濃度，結果發現上述各項除副甲狀腺素外母子均有統計上之差異。由上述結果推論新生兒之血鈣調節是由多種因素共同參與，而導致新生兒低血鈣症之重要因素，包括暫時性腎小管細胞對副甲狀腺素之低反應及維生素D代謝上之障礙。

並列摘要

The Ellsworth-Howard test was performed on 21 premature infants suffering from asymptomatic early neonatal hypocalcemia and on 10 premature controls. Serum calcitonin, parathyroid hormone, Plasma lα, 25(OH)2D3, and 25(OH)D3, levels were measured in all subjects and also in the mothers of the hypocalcemic neonates. The urinary C-AMP before and after parathyroid hormone (PTH) stimulation in Patients was much lower than that in normals, with the hypocalcemic neonates showing poor response of target organs to the parathyroid horomone. High serum calcitonin level, low plasma 25(OH)D3, and lα, 25(OH)2D3, levels were also demonstrated in the hypocalcemic neonates. The serum PTH level did not differ significantly. Serum phosphorous were significantly increased in the hypocalcemic neonates while their serum magnesium levels were normal. These results suggest that early neonatal hopocalcemia appears to be related to a transient lack of response to PTH of the target organs, disordered vitamin D metabolism and hypercalcitoninemia.

並列關鍵字

early neonatal hypocalcemia ； Ellsworth-Howard test ； 1α ； 25(OH)2D3 ； premature