孕晚期血清25羟基维生素D3水平及环境因素对早期婴儿湿疹的预测作用  

Predictive value of third trimester of pregnancy serum 25（OH）D3 and environmental risk factors for infantile eczema

作　　者：李晓瑞[1] 王新春[1] 朱丽红[2] LI Xiaorui;WANG Xinchun;ZHU Lihong(Department of Obstetric,the People′s Hospital of Xinjiang Uygur Autonomous Region,Xinjiang Uygur Autonomous Region,Urumqi831000,China;Department of Nursing,the People′s Hospital of Xinjiang Uygur Autonomous Region,Xinjiang Uygur Autonomous Region,Urumqi831000,China)

机构地区：[1]新疆维吾尔自治区人民医院产科,新疆乌鲁木齐831000 [2]新疆维吾尔自治区人民医院护理部,新疆乌鲁木齐831000

出　　处：《中国医药导报》2020年第5期87-90,94,共5页China Medical Herald

基　　金：新疆维吾尔自治区自然科学基金资助项目（2017D01C130）

摘　　要：目的探讨孕晚期血清25羟维生素D3[25(OH)D3]及环境因素对早期婴儿湿疹的预测作用。方法选择2016年1~12月在新疆维吾尔自治区人民医院产科门诊定期产检并住院分娩的528名孕妇为研究对象,建立队列,检测血清25(OH)D3水平,并对母婴进行6个月随访,观察婴儿湿疹的发生情况,分析孕晚期血清25(OH)D3水平对早期婴儿湿疹的预测作用。结果最终有505对母婴完成随访,有243例(48.1%)婴儿被诊断湿疹,其中56.4%(137/243)的婴儿湿疹集中发生在出生后2~3个月。根据湿疹的发生情况将婴儿分为湿疹组(n=243)和对照组(n=262),湿疹组母血25(OH)D3水平低于对照组(P<0.05)。ROC分析结果显示:曲线下面积为0.584,灵敏度为90.70%,特异度为14.17%,阳性预测值为50.18%,阴性预测值为61.52%,孕晚期母血25(OH)D3对婴儿湿疹的诊断价值较低。logistic回归分析结果显示:母亲过敏史阳性(OR=8.308,95%CI:5.131~13.45)、剖宫产分娩(OR=1.494,95%CI:0.977~2.286)、孕期经常被动吸烟(OR=1.386,95%CI:0.680~4.826)是婴儿湿疹的危险因素(P<0.05);而与孕晚期维生素D水平缺乏比较,孕晚期维生素D水平相对不足(OR=0.233,95%CI:0.138~0.392)和充足(OR=0.459,95%CI:0.270~0.779)均是婴儿湿疹的保护因素(P<0.05)。结论孕晚期血清中25(OH)D3对婴儿湿疹的预测价值较低。Objective To explore the predictive value of 25 hydroxyvitamin D3[25(OH)D3]and environmental risk factors for infantile eczema.Methods From January to December 2016,528 pregnant women who gave birth regularly in the obstetrical clinic of the People′s Hospital of Xinjiang Uygur Autonomous Region were selected as a cohort.Serums 25(OH)D3 levels of pregnant women were measured,and infants were followed up for 6 months to observe the occurrence of infant eczema,the predictive value of 25(OH)D3 for infants eczema was analyzed.Results Finally,505 pairs of mothers and infants completed,243 cases(48.1%)of the infants were diagnosed with eczema,of which eczema of 56.4%(137/243)infants occurred from 2 to 3 months after birth.According to the occurrence of eczema,the infants were divided into eczema group(n=243)and control group(n=262).The maternal 25(OH)D3 in eczema group was lower than control group(P<0.05).The results of ROC analysis showed that the area under curve was 0.584,the sensitivity was 90.70%,the specificity was 14.17%,the positive predictive value was 50.18%,the negative predictive value was 61.52%.Therefore,the diagnostic value of maternal 25(OH)D3 in the third trimester of pregnancy was low.Logistic regression analysis showed that the positive maternal allergy history(OR=8.308,95%CI:5.131-13.45),cesarean section delivery(OR=1.494,95%CI:0.977-2.286),frequent passive smoking during pregnancy(OR=1.386,95%CI:0.680-4.826)were the risk factors of infant eczema(P<0.05);but compared with 25(OH)D3 deficiency,low 25(OH)D3(OR=0.233,95%CI:0.138-0.392)and high 25(OH)D3(OR=0.459,95%CI:0.270-0.779)in late pregnancy were the protect factors of infant eczema(P<0.05).Conclusion There is a low predictive value of serum 25(OH)D3 in infantile eczema.

关 键 词：婴儿湿疹 孕晚期 环境因素 25羟基维生素D3 

分 类 号：R714.56[医药卫生—妇产科学]