冬季早期婴儿维生素D营养状况观察

Vitamin D status of early infants in winter in northern China

目的观察早期婴儿维生素D营养状况，为合理地补充维生素D提供依据。方法以我国北方地区冬季出生的72例婴儿为研究对象，自生后15d起口服维生素D补充剂，满月起逐月询问生活史和体检。于出生及4月龄时分别采集脐血和静脉血，测定血清25-（OH）D、钙、磷和碱性磷酸酶浓度。结果脐血25-（OH）D平均水平（21．91±5．75）nmol／L，72例（100．0％）维生素D缺乏；婴儿4月龄时血清25-（OH）D平均水平（108．12±45．30）nmol／L，10例（13．9％）维生素D缺乏。血清25-（0H）D平均水平在每日摄人维生素D200U～组升至（112．37±37．98）nmol／L，在400U～组升至（133．97±34．93）nmol／L。但维生素D不足和缺乏者在每日摄入维生素D200U～组6例（23．1％），400U～组仅2例（7．1％）。新生儿及婴儿血钙、磷、碱性磷酸酶水平均正常。结论北方地区冬季新生儿普遍存在维生素D缺乏，生后尽早补充可以显著改善维生素D营养状况。每日补充200U维生素D可显著提高早期婴儿血清25-（OH）D水平；若要达到维生素D营养充足，至少补充400U维生素D。

Objective To explore vitamin D status of early infants and provide the evidence for the application. Methods 72 subiects were selected from the infants who were born in winter in northern China. All subjects took vitamin D supplement from the 15th day after birth and accepted history and physical examination during the medication monthly. Um bilical cord blood at birth and the blood of infants at 4 months were collected. The levels of serum 25-（OH）D, calcium, phosphorus and alkaline phosphatase were measured. Results The serum 25-（OH）D level was （21.91±5.75）nmol/Lofcord blood and vitamin D status was deficiency in 72 （100.0%） cases. The serum 25-（OH）D level was （108.12±45.30） nmol/I. of infants and vitamin D status was deficiency Jn 10（13.9%） cases. The serum 25-（OH）D levels of vitamin D daily supplement of 200U-,400U- groups were （112.37±37.98）nmol/L and （133.97±34.93） nmol/L. There were 6（23. 1%） cases of the serum 25-（OH）D levels 〈75nmol/L in daily intake of vitamin D 200U-group and 2 cases （7. 1%） in 400U- group. Calcium,phosphorus,alkaline phosphatase levels of neonates and infants were normal. Conclusions Neonatal vita min D deficiency is prevalent in tee region. Intake sufficient vitamin D as soon as possible after birth could significantly improve neonatal and early infant vitamin D defieiency; vitamin D daily supplement of 200 U could significantly increase serum 25-（OH）D levels. In order to achieve adequate vitamin D nutrition for the general population,400U vitamin D is recommended.