Wolf H, Otten A
Klin Padiatr. 1983 Mar;195(2):86-91. doi: 10.1055/s-2008-1034047.
Physiological and clinical aspects are discussed in this review on calcium-phosphate metabolism in pre-term infants. Calcium accumulation in the bone mass of the foetus is related to the gestational age, and mainly occurs during the last weeks of gestation. Therefore, after birth, hypocalcemia is more frequent in pre-term than term infants. However, clinical symptoms of hypocalcemia, e.g. attacks of apnea, hyperexcitability and hypotonia, are rarely observed. Such symptoms depend upon the serum concentration of ionized calcium and this concentration is influenced by various metabolic factors. During the first two weeks of life phosphate is elevated in comparison to later periods. In spite of sufficient vitamin D supplementation low serum phosphate levels occur due to insufficient supply of phosphate. This correlates with evidence of rickets. An increased alkaline phosphatase activity can be considered an early and sensitive indicator. Pre-term infants develop rickets more frequently than term infants due to calcium-phosphate deficiency. Vitamin D supplementation alone is insufficient and should be combined with phosphate, as had been stated previously.
本文综述了早产儿钙磷代谢的生理和临床方面。胎儿骨骼中的钙积累与胎龄有关，主要发生在妊娠的最后几周。因此，出生后，早产儿比足月儿更容易发生低钙血症。然而，很少观察到低钙血症的临床症状，如呼吸暂停发作、过度兴奋和肌张力减退。这些症状取决于血清离子钙浓度，而该浓度受多种代谢因素影响。在出生后的前两周，与后期相比，磷酸盐水平升高。尽管补充了足够的维生素D，但由于磷酸盐供应不足，血清磷酸盐水平仍较低。这与佝偻病的证据相关。碱性磷酸酶活性增加可被视为一个早期且敏感的指标。由于钙磷缺乏，早产儿比足月儿更易患佝偻病。如之前所述，仅补充维生素D是不够的，应与磷酸盐联合使用。
