新生儿维生素K水平动态变化及影响因素  

Dynamic changes and influencing factors of vitamin K levels in neonates

作　　者：睢珍利 闫海霞[2] 张新华[1] Sui Zhenli;Yan Haixia;Zhang Xinhua(Department of Neonatology,Shanxi Children's Hospital Affiliated to Shanxi Medical University,Taiyuan 030006,China;Wuxi Health Vocational and Technical College,Wuxi 214111,China)

机构地区：[1]山西医科大学附属山西省儿童医院新生儿科,太原030006 [2]无锡卫生高等职业技术学校,无锡214111

出　　处：《中华新生儿科杂志（中英文）》2023年第9期525-529,共5页Chinese Journal of Neonatology

基　　金：国家卫生健康委医药卫生科技发展研究中心课题(WA2020HK59)。

摘　　要：目的了解新生儿脐血维生素K_(1)和维生素K_(2)缺乏率,探讨预防性补充维生素K_(1)后新生儿血清维生素K_(1)水平的动态变化及影响因素。方法选择2021年1月至2022年6月山西省儿童医院产科出生的新生儿进行前瞻性研究,检测脐血维生素K_(1)、K_(2)和补充维生素K_(1)后14 d、28 d血清维生素K_(1)水平,根据是否住院分为住院新生儿和健康新生儿,按照胎龄分为早中期早产儿、晚期早产儿和足月儿,计算不同胎龄新生儿脐血维生素K_(1)和维生素K_(2)缺乏率。应用SPSS 25.0统计软件比较住院早产儿与住院足月儿、健康足月儿与住院足月儿维生素K_(1)水平的动态变化,采用多因素logistic回归法分析住院新生儿28 d时维生素K_(1)水平的影响因素。结果共纳入100例新生儿。住院新生儿80例,其中早中期早产儿25例,晚期早产儿25例,足月儿30例;健康足月儿20例。不同胎龄新生儿脐血维生素K_(1)、K_(2)缺乏率差异无统计学意义(P>0.05),总体缺乏率均较高,分别为82.0%和84.0%。预防性补充维生素K_(1)后,足月儿组和早产儿组14 d时维生素K_(1)水平高于脐血,28 d时低于14 d时;住院足月儿组14 d、28 d时维生素K_(1)水平高于住院早产儿组,健康足月儿组28 d时维生素K_(1)水平高于住院足月儿组,差异均有统计学意义(P<0.05)。多因素logistic回归分析显示,母孕期有并发症(OR=5.889,95%CI 1.621~21.399,P=0.007)和新生儿使用抗生素(OR=5.615,95%CI 1.833~17.221,P=0.003)是新生儿维生素K_(1)缺乏的危险因素,配方奶喂养(OR=0.389,95%CI 0.193~0.786,P=0.008)是新生儿维生素K_(1)缺乏的保护因素。结论新生儿普遍存在维生素K缺乏。预防性补充维生素K_(1)后新生儿血清维生素K_(1)水平明显升高;住院足月儿14 d、28 d时维生素K_(1)水平高于住院早产儿。喂养方式、母孕期并发症和新生儿使用抗生素影响住院新生儿28 d时维生素K_(1)水平。Objective To study the incidences of vitamin K_(1) and K_(2) deficiency(VKD)in umbilical cord blood(UBC)of neonates and the dynamic changes and influencing factors of serum vitamin K_(1) levels after preventive vitamin K_(1) supplementation.Methods From January 2021 to June 2022,neonates born in the Obstetrics Department of our hospital were prospectively enrolled and the levels of vitamin K_(1) and K_(2) in UBC and serum vitamin K_(1) levels at 14 d and 28 d after vitamin K_(1) supplementation were measured.The neonates were assigned into hospitalization group and healthy group and further assigned into early-preterm,late-preterm and full-term groups based on gestational age(GA).The incidences of VKD of different GA were studied.Dynamic changes of vitamin K_(1) levels were calculated.Multivariate logistic regression was used to analyze the influencing factors of vitamin K_(1) levels in hospitalization group at 28 d.Results A total of 100 neonates were included.80 neonates were hospitalized,including 25 early-preterm,25 late-preterm and 30 full-term.20 were healthy full-term neonates.No significant differences existed in the incidences of VKD of different GA(P>0.05),however,the overall incidences were high(82.0%and 84.0%,respectively).After preventive vitamin K_(1) supplementation,the levels of vitamin K_(1) in full-term and preterm groups at 14 d were higher than at birth and 28 d.The levels of vitamin K_(1) in hospitalized full-term neonates at 14 d and 28 d were higher than hospitalized preterm neonates.The levels of vitamin K_(1) at 28 d in healthy group was significantly higher than hospitalization group(P<0.05).Multivariate logistic regression analysis showed that maternal complications during pregnancy(OR=5.889,95%CI 1.621-21.399,P=0.007)and neonatal antibiotic use(OR=5.615,95%CI 1.833-17.221,P=0.003)were risk factors and formula feeding(OR=0.389,95%CI 0.193-0.786,P=0.008)was a protective factor for VKD.Conclusions VKD is common in neonates.The serum vitamin K_(1) level increases significantly after preven

关 键 词：新生儿 维生素K_(1) 维生素K_(2) 维生素K缺乏性出血症 

分 类 号：R722.1[医药卫生—儿科]