中国儿童保健杂志 ›› 2021, Vol. 29 ›› Issue (5): 555-559.DOI: 10.11852/zgetbjzz2020-1570

• 临床研究 • 上一篇    下一篇

早产儿脐血血清25羟维生素D与呼吸窘迫综合征的关联性研究

张成强1, 陆澄秋1, 钱蓓倩1, 张彬2, 汪吉梅1   

  1. 复旦大学附属妇产科医院1.新生儿科;2.检验科,上海 200011
  • 收稿日期:2020-08-20 修回日期:2020-12-02 发布日期:2021-05-26
  • 通讯作者: 汪吉梅,E-mail:jimei_wang@126.com
  • 作者简介:张成强 (1989-),男,山东人,主治医师,硕士学位,博士在读,主要研究方向为新生儿心血管疾病的诊治。

Association between serum 25(OH)D level in cord blood and respiratory distress syndrome among preterm neonates

ZHANG Cheng-qiang*, LU Cheng-qiu, QIAN Bei-qian, ZHANG Bin, WANG Ji-mei   

  1. *Department of Neonatology, Obstetrics and Gynecology Hospital Affiliated to Fudan University, Shanghai 200011, China
  • Received:2020-08-20 Revised:2020-12-02 Published:2021-05-26
  • Contact: WANG Ji-mei, E-mail:jimei_wang@126.com

摘要: 目的 探讨早产儿脐血血清25羟维生素D[25(OH)D] 水平与呼吸窘迫综合征(RDS)的关系,为RDS的临床预防提供新思路。方法 将2018年3月—2020年5月收治入复旦大学附属妇产科医院NICU的179例早产儿纳入分析,于出生时采集脐血,使用化学发光微粒子免疫检测法分析测定脐血血清25(OH)D水平。根据是否诊断RDS分为RDS组和对照组,将血清25(OH)D水平是否低于20 ng/ml分为维生素D减少组和充足组,并分别分析和比较两组各影响因素的差异。结果 25.1%早产儿脐血25(OH)D水平缺乏(<10 ng/ml)、42.5%不足(10~<20 ng/ml),32.4%正常(≥20 ng/ml)。RDS组脐血血清25(OH)D水平[(11.3±7.2) ng/ml]显著低于对照组[(15.88±8.4)nmol/L], t=3.469,P<0.01);RDS组脐血血清25(OH)D减少发生率为89.0%(121/136),显著高于对照组 [46.5%(20/43), χ2=35.221, P<0.01)]。通过单因素和多因素分析,新生儿胎龄≤32周和脐血血清25(OH)D<20 ng/ml是早产儿发生RDS的独立危险因素(OR=39.694, 5.696, P<0.05)。结论 早产儿维生素D缺乏发生率高,低维生素D水平可能增加RDS发生率。

关键词: 25羟维生素D, 呼吸窘迫综合征, 危险因素, 早产儿

Abstract: Objective To investigate the relationship between serum 25 hydroxy vitamin D [25(OH) D] level and respiratory distress syndrome (RDS) in preterm infants,in order to provide new ideas for clinical prevention of RDS. Methods A total of 179 preterm infants admitted to NICU, Obstetrics and Gynecology Hospital Affiliated to Fudan University from March 2018 to May 2020 were included in the analysis.Cord blood was collected at birth, and the serum 25(OH)D level in cord blood was determined by chemiluminescent microparticle immunoassay.The infants were divided into RDS group and control group according to the diagnosis of RDS.According to whether serum 25(OH)D level was lower than 20 ng/ml, the infants were divided into vitamin D reduction group and normal group.The differences on the influencing factors between the two groups were analyzed and compared. Results Among all preterm infants, 25.1% were deficient in 25(OH)D level (<10 ng /ml), 42.5% were deficient (10—<20 ng/ml), and 32.4% were normal (≥20 ng/ml).The level of 25(OH)D in cord blood of RDS group [(11.3±7.2) ng/ml] was significantly lower than that of the control group [(15.88±8.4) nmol/L, t=3.469, P<0.01)].The prevalence of 25(OH)D decrease in RDS group was 89.0% (121/136), which was significantly higher than that in control group [46.5% (20/43), χ2= 35.221, P <0.01)].Multivariate analysis result indicated that gestational age and decreasing serum 25(OH)D level in cord blood were independent risk factors for RDS in preterm infants(OR=39.694, 5.696, P<0.05). Conclusion The prevalence of vitamin D deficiency in preterm infants is high, and it may increase the incidences of RDS.

Key words: 25 hydroxy vitamin D, respiratory distress syndrome, risk factors, infant, preterm infants

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