包头地区早产儿维生素D水平及影响因素分析  

Analysis on vitamin D level and influencing factors of premature infants in Baotou

作　　者：高宇君 王蔷[1] 陈艺丹 何海英[1] GAO Yujun;WANG Qiang;CHEN Yidan;HE Haiying(Department of Neonatal Pediatrics,the Third Staff Hospital of Baogang Group,Baotou 014010,China)

机构地区：[1]包钢集团第三职工医院新生儿科,内蒙古包头014010

出　　处：《包头医学院学报》2022年第7期9-12,50,共5页Journal of Baotou Medical College

摘　　要：目的:调查包头地区(北纬40o)早产儿25羟维生素D[25-hydroxyvitamin D,25(OH)D]水平并分析其影响因素以及维生素D水平与早产儿常见疾病之间的关系。方法:选取2018年11月-2020年11月于包钢集团第三职工医院新生儿科出生后48 h内入院且生命体征平稳的262例新生儿为研究对象。检测出生后14d血清25-(OH)D水平,并分析性别、胎龄、出生季节以及双胎与否对早产儿血清25(OH)D的影响。结果:早产儿25(OH)D平均水平为35.75(24.59,48.15)nmol/L,其中维生素D缺乏、不足及充足的发生率分别为32.38%、44.29%和23.33%,其中早产儿25(OH)D水平与其出生的季节之间差异有统计学意义(H=24.338,P<0.001),其中冬季出生的早产儿25(OH)D水平低于夏季及秋季(P<0.05),秋季出生的早产儿25(OH)D水平高于春季(P<0.05)。经有序Logistic回归分析发现早产儿出生季节之间的差异是维生素D水平低下的独立危险因素(P<0.05),且以秋季为著(P<0.01)。根据Mann-Whitney U检验发现新生儿代谢性骨病(Z=2.986,P=0.003)、新生儿坏死性小肠结肠炎(neonatal necrotizing enterocolitis,NEC)(Z=2.898,P=0.004)及新生儿感染(Z=2.916,P=0.004)的发生与25(OH)D水平具有相关性。结论:包头地区早产儿维生素D缺乏及不足的发生率较高,冬季出生的早产儿25(OH)D水平明显较低。胎龄是导致维生素D缺乏的危险因素。早产儿代谢性骨病、新生儿坏死性小肠结肠炎、新生儿感染的发生与25(OH)D水平具有相关性。Objective:To investigate the level of 25-hydroxyvitamin D[25-hydroxyvitamin D,25(OH)D]in premature infants in Baotou(40°N)and analyze its influencing factors and the relationship between vitamin D level and common diseases of premature infants.Methods:From November 2018 to November 2020,262 newborns admitted to the Department of Neonatology of the Third Staff Hospital of Baogang Group within 48 h after birth with stable vital signs were selected as the research objects.Serum 25(OH)D levels were detected 14 days after birth,and the effects of gender,gestational age,birth season and twins on serum 25(OH)D in premature infants were analyzed.Results:The average level of 25(OH)D in premature infants was 35.75(24.59,48.15)nmol/L,and the incidences of vitamin D deficiency,insufficiency and adequacy were 32.38%,44.29%and 23.33%,respectively.The difference of 25(OH)D level between premature infants and their birth seasons was statistically significant(H=24.338,P<0.001).The 25(OH)D level of premature infants born in winter was lower than that in summer and autumn(P<0.05),and the 25(OH)D level of premature infants born in autumn was higher than that in spring(P<0.05).Ordered Logistic regression analysis showed that the difference among birth seasons of premature infants was an independent risk factor for low vitamin D level(P<0.05),and autumn was the indigenous(P<0.01).According to Mann-Whitney U test,it was found that the occurrence of neonatal metabolic osteopathy(Z=2.986,P=0.003),neonatal necrotizing enterocolitis(NEC)(Z=2.898,P=0.004)and neonatal infection(Z=2.916,P=0.004)were correlated with 25(OH)D level.Conclusion:The incidence of vitamin D deficiency and insufficiency in premature infants in Baotou is higher,and 25(OH)D level in premature infants born in winter are significantly lower.Gestational age is a risk factor leading to vitamin D deficiency.The occurrence of metabolic bone disease,NEC and neonatal infections in premature infants is correlated with the level of 25(OH)D.

关 键 词：包头地区 早产儿 维生素D水平 影响因素 

分 类 号：R174[医药卫生—妇幼卫生保健]