早期补充维生素D对早产儿钙磷代谢及白细胞介素2的影响

The effects of early vitamin D supplementation on calcium and phosphorus metabolism and IL-2 level in premature infants

目的探讨早期口服不同剂量维生素D对早产儿钙磷代谢及白细胞介素2(IL-2)的影响。方法选择2012年1月至2014年1月入住我院新生儿监护病房的90例早产儿为研究对象,随机分为A组、B组和对照组,每组各30例;对照组给予配方奶喂养及部分肠外营养支持。A组生后第3天起给予口服维生素D 400 IU/d,连续14天;B组生后第3天起给予口服维生素D800 IU/d,连续14天。观察3组早产儿治疗前后血清Ca、P、25-(OH)D_3和IL-2水平变化。结果纳入分析87例,A组28例,B组29例,对照组30例。出生后第1天仅8例(9.2%)维生素D充足,各组早产儿维生素D充足比例差异无统计学意义(P>0.05);A组、B组治疗第7、14天维生素D充足比例高于对照组(P<0.05);A组与B组治疗第7天维生素D充足比例差异无统计学意义(P>0.05),治疗第14天B组充足比例高于A组(P<0.05)。口服维生素D前各组早产儿血清Ca、P、25-(OH)D_3、IL-2水平差异均无统计学意义(P>0.05);治疗第7天及第14天A组、B组血清Ca、P、25-(OH)D_3、IL-2水平均高于对照组,B组血清Ca、P、25-(OH)D_3、IL-2水平高于A组,差异有统计学意义(P<0.05)。结论早产儿生后第3天开始补充维生素D 800 IU/d较400 IU/d更能改善钙磷代谢状态,且可提高血清IL-2水平。

Objective To study the effects of early vitamin D supplementation on calcium （Ca） and phosphorus （P） metabolism and IL-2 level in preterm infants. Methods A total of 90 preterm infants admitted to NICU from January 2012 to January 2014 were enrolled into this study. They were assigned into group A, group B and control group randomly with 30 infants in each group. Formula feeding and partial parenteral nutrition （PPN） were given to the contro] group. Vitamin D 400 IU/d and 800 IU/d given orally for 14 d （from d3 to d16 after birth ） were given to group A and group B separately. Serum Ca~, P, 25, （OH）D3 and IL-2 levels were measured in all three groups before and after Vitamin D treatment. Results There were 87 cases （28 cases in group A, 29 cases in group B and 30 cases in the control group ）were analyzed. Only 8 cases （9. 2% ） had sufficient vitamin D on the first day after birth. Vitamin D deficiency was corrected in more babies from group A and B than the control group on d7 and d14 after vitamin D supplementation （P 〈 0. 05 ）. More babies in group B had sufficient vitamin D than group A on d14 and on d7, no differences were observed between the two groups. Ca,P, 25- （OH）D3 and IL-2 levels showed no differences in all groups on the first day after birth. Ca, P, 25- （OH）D3 in group A and B were higher than the control group on d7 and d14 after taking vitamin D （P 〈0. 05 ）, and Ca, P,25- （OH）D3 in group B were significantly higher than group A （P 〈 0. 05 ）. Conclusions Vitamin D 800 IU/d can improve the metabolism of calcium and phosphorus better than 400IU/d ,which helps raising the IL-2 level in serum.