抗菌药物对儿童血清维生素K水平及生长发育的影响  

Effects of Antibiotics on Serum Vitamin K Levels and Growth and Development in Children

作　　者：王朋 孔腾辉 王爱莲 张梦珍 刘骑睿 邓德明 韦皓[1] WANG Peng;KONG Tenghui;WANG Ailian;ZHANG Mengzhen;LIU Qirui;DENG Deming;WEI Hao(Dept.of Pediatrics,Affiliated Hospital of Chuanbei Medical College,Sichuan Nanchong 637000,China;Dept.of Pediatrics,Neijiang Maternal and Child Health Hospital,Sichuan Neijiang 641000,China)

机构地区：[1]川北医学院附属医院儿科,四川南充637000 [2]内江市妇幼保健院儿科,四川内江641000

出　　处：《中国医院用药评价与分析》2025年第1期33-36,共4页Evaluation and Analysis of Drug-use in Hospitals of China

基　　金：国家卫生健康委医药卫生科技发展研究中心项目(No.WA2020HK39)。

摘　　要：目的:分析孕妇围产期使用抗菌药物对新生儿血清维生素K水平的影响,以及3~14岁儿童使用抗菌药物对其血清维生素K水平及生长发育的影响。方法:(1)收集四川省内江市新生儿脐带血220例,采用医院信息系统(HIS)对其临床资料进行整理,按孕妇围产期是否使用抗菌药物分为A组(70例,抗菌药物暴露)和B组(150例,非抗菌药物暴露),分析孕妇围产期使用抗菌药物对新生儿血清维生素K水平的影响;(2)面对面问卷调查四川省南充市3~14岁儿童(60例)抗菌药物的使用频率,分为C组(30例,>3次/年)、D组(30例,≤3次/年),比较两组儿童的血清维生素K水平及骨龄差;(3)根据维生素K_(2)值将3~14岁儿童分为E组(20例,≥0.1 ng/mL)、F组(40例,<0.1 ng/mL),比较两组儿童的骨龄差;(4)根据身高将3~14岁儿童分为G组(26例,<P10)、H组(34例,P10-P90),比较两组儿童的血清维生素K水平、抗菌药物使用频率及骨龄差。结果:(1)B组新生儿血清维生素K_(1)、K_(2)≥0.1 ng/mL占比较A组高,差异有统计学意义(P<0.05);(2)C组儿童血清维生素K_(2)≥0.1 ng/mL占比较D组低,血清维生素K_(1)水平较D组低,骨龄差较D组大,差异均有统计学意义(P<0.05);(3)E组儿童骨龄差较F组小,差异有统计学意义(P<0.05);(4)G组儿童血清维生素K_(2)≥0.1 ng/mL占比较H组低,差异有统计学意义(P<0.05),G组、H组儿童血清维生素K_(1)水平、抗菌药物使用频率和骨龄差比较,差异均无统计学意义(P>0.05)。结论:>3次/年的抗菌药物暴露会降低儿童血清维生素K水平、增加骨龄,血清维生素K_(2)水平的降低与儿童身材偏矮及骨龄增加相关,反复的抗菌药物暴露可能通过影响血清维生素K水平、骨龄,进而影响儿童生长发育。OBJECTIVE:To analyze the effects of maternal perinatal use of antibiotics on neonatal serum vitamin K levels,and the effects of antibiotics on serum vitamin K levels and growth and development of children aged from 3 to 14 years.METHODS:(1)Clinical data of 220 cases of neonatal umbilical cord blood in Sichuan Neijiang were collected and sorted by HIS system.Patients were divided into the group A(70 cases,antibiotic exposure)and group B(150 cases,non-antibiotic exposure)according to maternal perinatal use of antibiotics.Effects of maternal perinatal use of antibiotics on serum vitamin K levels of newborns were analyzed.(2)The use frequency of antibiotics in children aged from 3 to 14 years(60 cases)in Sichuan Nanchong was investigated by face-to-face questionnaire,and the children were divided into the group C(30 cases,>3 times/year)and group D(30 cases,≤3 times/year).The vitamin K value and bone age difference between two groups were compared.(3)Children aged from 3 to 14 years were divided into the group E(20 cases,≥0.1 ng/mL)and group F(40 cases,<0.1 ng/mL)according to vitamin K_(2) levels,and the bone age difference between two groups was compared.(4)According to the height,the children aged from 3 to 14 years were divided into the group G(26 cases,<P10)group H(34 cases,P10 to P90),the serum vitamin K levels,use frequency of antibiotics and bone age were compared.RESULTS:(1)The proportion of serum vitamin K_(1) and K_(2)≥0.1 ng/mL in group B were higher than those in group A,the difference was statistically significant(P<0.05).(2)The proportion of serum vitamin K_(2)≥0.1 ng/mL in group C was lower than that in group D,the level of serum vitamin K_(1) was lower than that in group D,and the difference in bone age was larger than that in group D,with statistical significant differences(P<0.05).(3)The difference of bone age in group E was smaller than that in group F,with statistical significant differences(P<0.05).(4)The proportion of serum vitamin K_(2)≥0.1 ng/mL in group G was lower than that in group

关 键 词：维生素K 儿童 抗菌药物 生长发育 

分 类 号：R978.1[医药卫生—药品]