维生素A和25(OH)D与新生儿高胆红素血症的相关研究  

Correlation of vitamin A and 25(OH)D with neonatal hyperbilirubinemia

作　　者：王丹丹 曲艳杰[2] 高淑青[2] 王冬梅[2] WANG Dan-dan;QU Yan-jie;GAO Shu-qing;WANG Dong-mei(Baotou Medical College,Baotou,Inner Mongolia,014040,China;不详)

机构地区：[1]包头医学院,内蒙古包头014040 [2]包头市第四医院

出　　处：《中国冶金工业医学杂志》2022年第5期500-502,共3页Chinese Medical Journal of Metallurgical industry

摘　　要：目的 通过病例对照研究的方法,检测新生儿高胆红素血症(NHB)患儿血清维生素A、25羟维生素D[25(OH)D]的浓度,探讨新生儿血清胆红素水平与血清维生素A、25(OH)D的关系,同时了解高胆红素血症对脏器功能的影响。方法 选取2020年1月至2021年5月于包头市第四医院新生儿科住院的NHB患儿116例为观察组,包括NHB轻度组86例和NHB重度组30例;随机选取同一时期的非NHB新生儿30例为对照组。比较3组患儿血清维生素A、25(OH)D、胱抑素C(CysC)、尿酸(UA)、尿素氮(BUN)及肌酐(sCr)水平,对差别有统计学意义的指标进行多因素Logistic回归分析,应用ROC曲线评价其对NHB的预测价值。结果 (1)3组血清维生素A、25(OH)D水平比较显示重度组<轻度组<对照组(F=11.910、17.351,均P<0.05),而血清CysC水平比较显示重度组>轻度组>对照组(F=9.445,P<0.05);3组UA、BUN及sCr水平的比较差异均无统计学意义(Z=0.780、1.860、3.054,均P>0.05);(2)血清维生素A、25(OH)D、CysC预测NHB的截断值分别为0.14 mg/L、10.55 ng/ml、1.59 mg/L,敏感度分别为86.70%、80.00%、72.40%,特异度分别为57.80%、69.00%、63.30%;(3)血清维生素A、25(OH)D和CysC联合预测NHB的敏感度为84.50%、特异度为76.70%,高于单项检测。结论 维生素A与25(OH)D是NHB的保护因素,而CysC是预测NHB的危险因素;血清维生素A、25(OH)D及CysC三者联合检测,可以早期识别和评估NHB发生的风险,从而降低NHB造成的继发性损害。Objective To determine the concentration of serum vitamin A and 25(OH)D in neonatal hyperbilirubinemia(NHB)by case-control study and to explore the relationship between serum bilirubin level and serum vitamin A and 25(OH)D in neonates. At the same time to understand the influence of hyperbilirubinemia on organ function. Methods A total of 116 NHB who were admitted to the neonatal department of the fourth hospital of Baotou from January 2020 to May 2021 were selected as the observation group, including the mild NHB group(n=86)and the severe NHB group(n=30). 30 healthy newborns of non-NHB were randomly selected as the control group. Serum levels of vitamin A, 25(OH)D,cystatin C(CysC), uric acid(UA), urea(BUN)and creatinine(sCr)were compared among the three groups. Multivariate logistic regression analysis was performed for the statistically significant indexes, and ROC curve was used to evaluate their predictive value for NHB. Results(1)The comparison of serum vitamin A and 25(OH)D levels among the three groups showed that the severe group was lower than the mild group and the control group(F=11.910,17.351, P<0.05), and the comparison of serum CysC levels showed that the severe group was higher than the mild group and the control group(F=9.445, P<0.05). There were no significant differences in UA, BUN and s Cr levels among the three groups(Z=0.780,1.860,3.054, all P>0.05).(2)The cut-off values of serum vitamin A, 25(OH)D and CysC for NHB prediction were 0.14 mg/L, 10.55 ng/ml and1.59 mg/L respectively, with sensitivity of 86.70%, 80.00% and 72.40%, and specificity of 57.80%, 69.00% and 63.30%, respectively.(3)The sensitivity and specificity of serum vitamin A, 25(OH)D and CysC combined to predict NHB were 84.50% and 76.70%, which were higher than those of single detection. Conclusion Vitamin A and 25(OH)D are the protective factors for NHB, while CysC is a risk factor for predicting NHB. Combined detection of serum vitamin A, 25(OH)D and CysC can identify and assess the risk of NHB early, so as to reduce the second

关 键 词：高胆红素血症 新生儿 维生素A 25(OH)D 胱抑素C 

分 类 号：R722.17[医药卫生—儿科]