补充不同剂量维生素D对极低出生体重儿骨代谢及体格指标的影响  

Influence of the different doses of vitamin D supplementation for infants with very low birth weight on their bone metabolism and physique indicators

作　　者：方静 饶晓红 FANG Jing;RAO Xiaohong(Hejiang County Hospital of Traditional Chinese Medicine,Luzhou,Sichuan Province,646200;Affiliated Hospital of Southwest Medical University,Luzhou)

机构地区：[1]四川省合江县中医医院,646200 [2]西南医科大学附属医院

出　　处：《中国计划生育学杂志》2024年第10期2312-2316,共5页Chinese Journal of Family Planning

摘　　要：目的:探讨补充不同剂量维生素D对极低出生体重儿骨代谢及体格指标的影响。方法:选取2022年1月-2023年12月在合江县中医医院和西南医科大学附属医院分娩的极低出生体重儿85例,按照简单随机分组法分为低剂量组(n=28)、中剂量组(n=28)、高剂量组(n=29),分别给予400IU/d、600IU/d、800IU/d维生素D补充,3组均干预4周,对比干预前后血清25-羟基维生素D[25(OH)D]水平,骨代谢指标[血清钙(Ca)、磷(P)、碱性磷酸酶(AKP)]及体格指标,统计并发症发生情况。结果:干预后,3组血清25(OH)D和Ca、AKP水平均升高,高剂量组P水平升高(P<0.05),且高剂量组血清25(OH)D水平(66.73±9.68ng/ml)、P水平(2.05±0.24mmol/L)高于其他两组,AKP水平(506.75±110.34U/L)低于其他两组(P<0.05),Ca水平(2.30±0.25 mmol/L)与其他两组无差异(P>0.05);中剂量组血清25(OH)D水平(58.48±10.23ng/ml)高于低剂量组(50.35±8.27ng/ml),AKP水平(553.48±118.20U/L)低于低剂量组(591.41±123.10U/L)(均P<0.05),Ca、P水平与低剂量组无差异(P>0.05);3组超声骨密度值均增大,且高剂量组超声骨密度值(2934.55±127.78m/s)大于其他两组(均P<0.05),中剂量组与低剂量组无差异(P>0.05)。高剂量组身高增长速度(0.93±0.35cm/周)和体重增长速度(15.08±2.49g/周)均大于其他两组,头围增长速度(0.63±0.23cm/周)大于低剂量组,中剂量组身高增长速度和体重增长速度均大于低剂量组(均P<0.05),头围增长速度中剂量组与低剂量组无差异(P>0.05)。高剂量组、中剂量组、低剂量代谢性骨病(0、3.6%、7.1%)、支气管肺发育不良(13.8%、17.9%、17.9%)、早产儿视网膜病变(10.3%、7.1%、7.1%)发生率均未见差异(P>0.05)。结论:不同剂量维生素D均可改善极低出生体重儿骨代谢,促进体格发育,而高剂量(800IU/d)维生素D补充后改善效果最为显著。Objective:To analyze the influence of the different doses of vitamin D supplementation for infants with very low birth weight on their bone metabolism and physique indicators.Methods:A total of 85 infants with very low birth weight who were delivered in the hospital from January 2022 to December 2023 were selected and were divided into three groups by the simple random grouping method.28 infants in group A were given 400 IU/d vitamin D supplemen-tation for 4 weeks,28 infants in group B were given 600 IU/d vitamin D supplementation for 4 weeks and 29 infants in group B were given 800 IU/d vitamin D supplementation for 4 weeks.The level of serum 25-hydroxyvitamin D(25-(OH)D),the levels of bone metabolism indicators,such as serum calcium(Ca),phosphorus(P)and alkaline phos-phatase(AKP),the physique indicators values and the complication rate of the infants before and after intervention were compared between the three groups.Results:The levels of serum 25(OH)D,Ca and AKP of the infants in the three groups after intervention had increased significantly,and the P level of the infants in group C after intervention had increased significantly(P<0.05).The levels of serum 25(OH)D(66.73±9.68ng/m)and P(2.05±0.24 mmol/L)of the infants in group C were significantly higher than those of the infants in the other two groups,and the AKP level(506.75±110.34 U/L)of the infants in group C was significantly lower than that of the infants in the other two groups(P<0.05).The Ca level(2.30±0.25 mmol/L)of the infants in group C had no significantly different from that of the infants in the other two groups(P>0.05).The serum 25(OH)D level(58.48±10.23ng/ml)of the infants in group B was significantly higher than that(50.35±8.27ng/ml)of the infants in group A,and the AKP level(553.48±118.20U/L)of the infants in group B was significantly lower than that(591.41±123.10U/L)of the infants in group A(all P<0.05).There was no significant difference in the Ca and P levels of the infants between group B and group A(P>0.05).The ultrasound bone m

关 键 词：极低出生体重儿 维生素D 骨代谢 体格 不良反应 

分 类 号：R722.1[医药卫生—儿科]