早产儿脐带血钙、磷、镁和碱性磷酸酶的胎龄特异性参考区间。
Cord blood calcium, phosphate, magnesium, and alkaline phosphatase gestational age-specific reference intervals for preterm infants.
机构信息
Department of Community Health Sciences, University of Calgary, 3280 Hospital Drive NW, Calgary, Alberta, Canada.
出版信息
BMC Pediatr. 2011 Aug 31;11:76. doi: 10.1186/1471-2431-11-76.
BACKGROUND
The objective was to determine the influence of gestational age, maternal, and neonatal variables on reference intervals for cord blood bone minerals (calcium, phosphate, magnesium) and related laboratory tests (alkaline phosphatase, and albumin-adjusted calcium), and to develop gestational age specific reference intervals based on infants without influential pathological conditions.
METHODS
Cross-sectional study. 702 babies were identified as candidates for this study in a regional referral neonatal unit. After exclusions (for anomalies, asphyxia, maternal magnesium sulfate administration, and death), relationships were examined between cord blood serum laboratory analytes (calcium, phosphate, magnesium, alkaline phosphatase, and albumin-adjusted calcium) with gestation age and also with maternal and neonatal variables using multiple linear regression. Infants with influential pathological conditions were omitted from the development of gestational age specific reference intervals for the following categories: 23-27, 28-31, 32-34, 35-36 and > 36 weeks.
RESULTS
Among the 506 preterm and 54 terms infants included in the sample. Phosphate, magnesium, and alkaline phosphatase in cord blood serum decreased with gestational age, calcium increased with gestational age. Those who were triplets, small for gestational age, and those whose mother had pregnancy-induced hypertension were influential for most of the analytes. The reference ranges for the preterm infants ≥ 36 weeks were: phosphate 1.5 to 2.6 mmol/L (4.5 to 8.0 mg/dL), calcium: 2.1 to 3.1 mmol/L (8.3 to 12.4 mg/dL); albumin-adjusted calcium: 2.3 to 3.2 mmol/L (9.1 to 12.9 mg/dL); magnesium 0.6 to 1.0 mmol/L (1.4 to 2.3 mg/dL), and alkaline phosphatase 60 to 301 units/L.
CONCLUSIONS
These data suggest that gestational age, as well as potentially pathogenic maternal and neonatal variables should be considered in the development of reference intervals for preterm infants.
背景
目的是确定胎龄、产妇和新生儿变量对脐带血骨矿物质（钙、磷、镁）和相关实验室检测（碱性磷酸酶和白蛋白校正钙）参考区间的影响，并根据无影响病理情况的婴儿制定特定胎龄的参考区间。
方法
这是一项横断面研究。在一个区域性转诊新生儿病房中，确定了 702 名婴儿符合本研究条件。排除异常、窒息、母亲硫酸镁治疗和死亡的婴儿后，使用多元线性回归分析脐带血血清实验室检测（钙、磷、镁、碱性磷酸酶和白蛋白校正钙）与胎龄以及与产妇和新生儿变量之间的关系。有影响病理情况的婴儿被排除在以下分类的特定胎龄参考区间的制定之外：23-27、28-31、32-34、35-36 和>36 周。
结果
在纳入的 506 名早产儿和 54 名足月婴儿中，脐带血血清中的磷酸盐、镁和碱性磷酸酶随胎龄下降，钙随胎龄增加。三胞胎、小于胎龄儿和母亲患有妊娠高血压的婴儿对大多数分析物有影响。≥36 周早产儿的参考范围为：磷 1.5 至 2.6mmol/L（4.5 至 8.0mg/dL），钙：2.1 至 3.1mmol/L（8.3 至 12.4mg/dL）；白蛋白校正钙：2.3 至 3.2mmol/L（9.1 至 12.9mg/dL）；镁 0.6 至 1.0mmol/L（1.4 至 2.3mg/dL），碱性磷酸酶 60 至 301 单位/L。
结论
这些数据表明，胎龄以及潜在的致病产妇和新生儿变量应在早产儿参考区间的制定中考虑。
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