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目的探讨新生儿甲状旁腺功能减退症(简称甲旁减)的临床特征及治疗。方法回顾性分析本院2004年5月至2010年5月收治的新生儿甲旁减患儿的临床资料。结果 20例患儿中男12例,女8例;发病日龄2～28 d。母亲甲状旁腺功能亢进5例,糖尿病母亲婴儿6例,新生儿缺氧缺血性脑病4例。主要表现为惊厥20例,肢体抖动18例,面色发绀6例,水肿6例,转移性钙化4例。血钙降低20例,血磷增高14例,甲状旁腺素(PTH)降低10例,正常5例,轻度增高5例。经钙剂和维生素D及其衍生物治疗,18例临床症状消失带药出院,2例放弃治疗。13例患儿自生后1个月至3年于内分泌门诊随访,生长发育正常;3例不明原因死亡;4例失访。结论新生儿期甲旁减少见,以暂时性多见。遇难治性低钙血症应检查血钙、磷、PTH水平,需注意母亲隐匿性甲状旁腺功能亢进。钙剂和维生素D及衍生物治疗有效,治疗中应注意预防高钙血症。
Objective To investigate the clinical features and treatment of neonatal hypoparathyroidism (abbreviated as CPN). Methods Retrospective analysis of the clinical data of neonatal paraparaphy in our hospital from May 2004 to May 2010. Results Among the 20 children, 12 were male and 8 were female; the age of onset was from 2 to 28 days. 5 cases of hyperparathyroidism in mothers, 6 cases of diabetic mothers and 4 cases of neonatal hypoxic-ischemic encephalopathy. The main manifestations of convulsions in 20 cases, 18 cases of limb jitter, 6 cases of cyanosis, edema in 6 cases, 4 cases of metastatic calcification. 20 cases of decreased serum calcium, 14 cases of elevated phosphorus, parathyroid hormone (PTH) reduced in 10 cases, 5 cases of normal, mild increase in 5 cases. The treatment of calcium and vitamin D and its derivatives, 18 cases of clinical symptoms disappeared with the drug was discharged, 2 patients gave up treatment. Thirteen children were followed up in endocrinology clinics from one month to three years after their birth, with normal growth and development; three died of unknown causes; and four were lost to follow-up. Conclusions Parasitism is reduced in neonatal period, which is more common than temporary. In case of refractory hypocalcemia should check the blood calcium, phosphorus, PTH levels, should pay attention to the mother occult hyperparathyroidism. Calcium and vitamin D and derivatives effective treatment, treatment should pay attention to prevent hypercalcemia.