低剂量维生素D辅助蓝光治疗新生儿黄疸的单中心随机对照研究  

Low-dose vitamin D supplementation combined with blue light radiation for treatment of neonatal jaundice:a single-center randomized controlled study

作　　者：冯慧玲[1] 冯孝强[1] 李帆 白媛[1] 杨莹莹 姜泓[1] 张渊韬 FENG Huiling;FENG Xiaoqiang;LI Fan;BAI Yuan;YANG Yingying;JIANG Hong;ZHANG Yuantao(Department of Neonatology,The Affiliated Hospital of Yan′an University,Shaanxi Yan′an 716000,China)

机构地区：[1]延安大学附属医院新生儿科,陕西延安716000

出　　处：《中国妇幼健康研究》2023年第4期74-79,共6页Chinese Journal of Woman and Child Health Research

摘　　要：目的探讨低剂量维生素D辅助蓝光治疗对新生儿黄疸的临床价值。方法选取我院2018年1月至2020年1月收治的286例病理性黄疸新生儿为研究对象,采用随机数字表法将其分为观察组(n=143)和对照组(n=143)。对照组采取蓝光治疗,观察组采取蓝光联合低剂量维生素D治疗。比较两组患儿的治疗效果、光疗持续时间、血清胆红素和25-(OH)D水平,以及再次治疗、维生素D缺乏和不良反应情况。结果治疗前两组患儿血清胆红素水平差异无统计学意义(P>0.05),治疗后均明显降低,且观察组治疗1~3d的血清胆红素水平低于对照组(t值分别为2.849、7.736和5.304,P<0.05)。观察组光疗持续时间明显较对照组短(t=4.868,P<0.05),再次治疗率较对照组低(χ^(2)=19.928,P<0.05)。治疗后观察组的血清25-(OH)D水平明显升高而对照组明显降低,且出院前观察组25-(OH)D水平明显高于对照组(t=8.679,P<0.05),维生素D缺乏率明显低于对照组(χ^(2)=17.727,P<0.05)。观察组患儿的治疗总有效率(94.41%)高于对照组患儿(87.41%),差异有统计学意义(χ^(2)=4.231,P<0.05)。治疗期间不良反应为发热、皮疹、腹泻、青铜症,观察组的不良反应率(4.20%)低于对照组(11.19%),差异有统计学意义(χ^(2)=4.924,P<0.05)。结论低剂量维生素D辅助蓝光治疗可有效降低新生儿胆红素水平,缩短光疗持续时间,提高25-(OH)D水平,减少蓝光治疗相关不良反应,增强黄疸的治疗效果。Objective To investigate clinical therapeutic effect of low-dose vitamin D supplementation combined with blue light radiation therapy for neonatal jaundice.Methods 286newborns with pathological jaundice who were treated in our hospital from January 2018to January 2020were enrolled as study subjects.In random number table method,the newborns were divided into observation group(n=143)and control group(n=143)randomly.The newborns with pathological jaundice in the control group were treated with blue light radiation alone,and those in the observation group were treated with blue light radiation combined with oral administration of lower-dose vitamin D.The therapeutic effect,phototherapy duration,serum bilirubin and 25-(OH)D level,as well as rates of repeated phototherapy,vitamin D deficiency and adverse reactions were compared between the two groups.Results There was no significant difference in serum level of bilirubin of the newborns between the two groups before treatment(P>0.05),while the serum levels of bilirubin of the newborns in both two groups decreased significantly after treatment,and the serum levels of bilirubin of the newborns in the observation group at d1,d2and d3after treatment were lower than those in the control group(t=2.849,7.736 and 5.304respectively,all P<0.05).The duration of phototherapy in the observation group was significantly shorter than that in the control group(t=4.868,P<0.05),and the repeated phototherapy rate was lower than that in the control group(χ^(2)=19.928,P<0.05).After treatment,the serum 25-(OH)D level of the newborns in the observation group rose significantly,while that of the newborns in the control group significantly lowered,furthermore,at discharge,the serum 25-(OH)D level of the newborns in the observation group was significantly higher than that in the control group(t=8.679,P<0.05),and the vitamin D deficiency rate was significantly lower than that in the control group(χ^(2)=17.727,P<0.05).The total clinical effective rate in the observation group was higher than th

关 键 词：维生素D 蓝光治疗 新生儿黄疸 高胆红素血症 临床疗效 

分 类 号：R174[医药卫生—妇幼卫生保健]