接受光疗的新生儿低钙血症患病率：系统综述与荟萃分析。
完整摘要 · 中文译文
背景：尽管光疗是新生儿高胆红素血症的标准治疗方法，但其不良反应会导致电解质紊乱。关于光疗所致低钙血症患病率的汇总证据在各研究间仍不一致。因此，本系统综述与荟萃分析旨在确定接受光疗新生儿低钙血症的合并发生率。 方法：本系统综述与荟萃分析按照2020年PRISMA指南开展。检索相关数据库以获取截至2026年2月报告高胆红素血症新生儿低钙血症的观察性研究。对检索到的文章进行去重清理，并根据纳入标准进行筛选。使用STATA 17.0软件通过随机效应模型计算低钙血症的合并发生率及其95%置信区间。通过I2统计量和Cochran's Q检验评估异质性，而通过留一法敏感性分析和亚组分析评估稳健性。此外，通过Egger回归检验、Begg秩相关检验和剪补法校正评估发表偏倚。 结果：本荟萃分析共纳入25项研究，涉及2673名新生儿。接受光疗新生儿低钙血症的合并患病率估计为20.68%（95% CI：15.75-25.60%）。存在显著异质性（I2 = 94.15%，p < 0.001）。在亚组分析中，早产儿（23.03%，95% CI：14.18% - 31.88%）和低出生体重 (22.57%，95% CI：14.99% - 30.16%) 新生儿，高于足月（18.51%，95% CI：12.39% - 24.63%）和正常出生体重（13.97%，95% CI：8.72% - 19.17%）新生儿。非洲的低钙血症发生率（36.00%，95% CI：7.52% - 64.47%）高于亚洲（18.89%，95% CI：14.02% - 23.76%）。Egger检验显示存在显著发表偏倚（p < 0.0001），经剪补法分析后原始效应量无显著变化。 结论：低钙血症是接受光疗的新生儿高胆红素血症患儿中常见的电解质紊乱。因此，定期监测至关重要，尤其是对于高危患儿。
完整摘要 · 英文原文
BACKGROUND: Although phototherapy is the standard treatment for neonatal hyperbilirubinemia, its adverse effects cause electrolyte disturbances. Aggregated evidence regarding the prevalence of phototherapy-induced hypocalcemia remains inconsistent across studies. Therefore, this systematic review and meta-analysis aimed to determine the pooled incidence hypocalcemia in neonates receiving phototherapy. METHODS: This systematic review and meta-analysis were conducted in compliance with the 2020 PRISMA guidelines. Relevant databases were searched to retrieve observational studies reporting hypocalcemia among neonates with hyperbilirubinemia through February 2026. The retrieved articles were cleaned for duplicates and selected based on the eligibility criteria. STATA 17.0 software was used to compute the pooled hypocalcemia with 95% confidence intervals via a random effects model. Heterogeneity was assessed via the I2 statistic and Cochran's Q test, whereas robustness was evaluated via leave-one-out sensitivity analysis and subgroup analysis. Furthermore, publication bias was assessed by Egger's regression test, Begg's rank correlation test, and trim-and-fill correction. RESULTS: In total, 25 studies involving 2673 neonates were included in the meta-analysis. The pooled prevalence of hypocalcemia in neonates undergoing phototherapy was estimated to be 20.68% (95% CI: 15.75-25.60%). There was significant heterogeneity (I2 = 94.15%, p < 0.001). In the subgroup analysis, there was a greater hypocalcemia in studies with preterm (23.03%, 95% CI: 14.18% - 31.88%) and low birth weight (22.57%, 95% CI: 14.99% - 30.16%) neonates than in those with term (18.51%, 95% CI: 12.39% - 24.63%) and normal birth weights (13.97%, 95% CI: 8.72% - 19.17%). The hypocalcemia was higher in Africa (36.00%, 95% CI: 7.52% - 64.47%) than in Asia (18.89%, 95% CI: 14.02% - 23.76%). Egger's test revealed significant publication bias (p < 0.0001), with no significant change in the original effect size after trim-and-fill analysis. CONCLUSION: Hypocalcemia is a frequent electrolyte disorder in neonates under phototherapy with neonatal hyperbilirubinemia. Thus, regular monitoring is essential, particularly for those who are at high risk.