急性呼吸窘迫综合征新生儿低血清25-羟维生素D_(3)水平对预后的影响  

Effect of low serum 25-hydroxyvitamin D_(3)levels on prognosis in neonates with acute respiratory distress syndrome

作　　者：杨伟丽 杨娟娟 龙云霞 莫林荣 谢勇 邓毅 YANG Weili;YANG Juanjuan;LONG Yunxia;MO Linrong;XIE Yong;DENG Yi(Department of Neonatology,the Second Affiliated Hospital of Guilin Medical University,Guilin,Guangxi 541199,China)

机构地区：[1]桂林医学院第二附属医院新生儿科,广西桂林541199

出　　处：《中国优生与遗传杂志》2022年第10期1796-1801,共6页Chinese Journal of Birth Health & Heredity

基　　金：广西医疗卫生重点培育学科建设项目(桂卫科教发[2019]19号)。

摘　　要：目的 探讨急性呼吸窘迫综合征(ARDS)新生儿低血清25-羟维生素D[25(OH)D_(3)]水平对预后的影响。方法 将2019年10月至2021年10月于桂林医学院第二附属医院治疗的88例ARDS患儿根据预后情况分为预后良好组(60例)和预后不良组(28例),比较两组患儿的一般资料;多因素Logistic回归分析影响患儿预后不良的危险因素;Pearson检验分析各影响因素间的相关性;受试者操作特征(ROC)曲线评估模型的准确性和血清25(OH)D_(3)对患儿预后不良的预测价值。结果 多因素Logistic回归分析结果显示,胎龄小、血清25(OH)D_(3)水平低和白蛋白(ALB)低是ARDS患儿预后不良的独立危险因素(P<0.05),急性生理和慢性疾病评分(APACHEⅡ评分)、高迁移率族蛋白B1(HMGB1)、白细胞介素-6(IL-6)、中性粒细胞明胶酶相关脂质运载蛋白(NGAL)、白细胞计数(WBC)降低为ARDS患儿预后不良的保护因素(P<0.05);各危险因素间具有显著相关性(P<0.05);ROC曲线结果显示,模型准确度较高,血清25(OH)D_(3)水平能够有效预测患儿预后。结论 ARDS新生儿低血清25(OH)D_(3)水平是预后不良的危险因素,临床应重点关注。Objective Objective to investigate the effect of low serum 25-hydroxyvitamin D[25(OH)D_(3)]level on prognosis in neonates with acute respiratory distress syndrome (ARDS).Methods According to the prognosis,88 children with ARDS treated in the Second Affiliated Hospital of Guilin Medical University from October 2019 to October 2020 were divided into good prognosis group (60 cases) and poor prognosis group (28 cases),and the general data of the two groups were compared.Multivariate Logistic regression analysis of risk factors for poor prognosis in children.Pearson test was used to analyze the correlation among the influencing factors.The accuracy of author characteristic curve evaluation model and the predictive value of serum 25(OH)D_(3)for poor prognosis of children.Results Multivariate Logistic regression analysis showed that small gestational age,low serum 25(OH)D_(3)level and low albumin (ALB) level were independent risk factors for poor prognosis of ARDS children (P<0.05).Acute physiological and chronic disease score (APACHEⅡscore),high mobility group protein B1 (HMGB1),interleukin-6 (IL-6),neutrophil gelatinase-associated lipid carrier protein (NGAL) and white blood cell count (WBC) were the protective factors for poor prognosis of ARDS children (P<0.05).There was significant correlation among risk factors (P<0.05).ROC curve results showed that the model had high accuracy,and serum 25(OH)D_(3)level could effectively predict the prognosis of children.Conclusion The low level of serum 25(OH)D_(3)in neonates with ARDS is a risk factor for poor prognosis and should be paid more attention in clinic.

关 键 词：急性呼吸窘迫综合征 血清25-羟维生素D_(3) 预后不良 生存曲线 

分 类 号：R722.1[医药卫生—儿科]