新生儿早期早产儿补充维生素D的临床效果观察

Observation on clinical effect of early neonatal vitamin d supplementation in preterm infants

目的了解早产儿提早补充维生素D的临床效果。方法选取沧州市人民医院新生儿科早产儿158例,分为大胎龄组和小胎龄组,每组又随机分为对照组和实验组,对照组给予配方奶喂养,实验组在对照组基础上,于生后第3天开始补充维生素D 400 IU/d,服用7 d,实验前后测定血清钙、磷和25-(OH)D水平,观察临床有无并发症。结果早产儿普遍存在维生素D缺乏,维生素D缺乏比例为97.4%。血清钙、磷和25-(OH)D水平实验组较对照组明显提高,小胎龄组和大胎龄组实验组血清25-(OH)D均值分别从23.556 nmol/L、27.771 nmol/L提高到27.423 nmol/L、32.198 nmol/L,具有明显差异(P<0.05)。早产儿服用维生素D 400 IU/d,并无毒性。结论早产儿生后及早期监测维生素D状态,第3天开始补充维生素D,是早产儿健康支持的重要措施。

Objective To study the clinical effect of early neonatal vitamin D supplementation in preterm infants. Meth- ods In the study, 158 preterm infants from Cangzhou People＇ s Hospital were selected and divided into the large for ges- tational age group and small for gestational age group, each group was randomly divided into control group and experimen- tal group, the control group was given formula feeding, the experimental group on the basis of the control group,was fed vi- tamin D intake 400 IU/d from 3rd to 10th day after birth, serum calcium, phosphorus and 25-（OH） D were tested before and after the experiment,and vitamin D toxicity was observed. Results It was high prevalence of moderately severe vita- min D deficiency in preterm infants. The proportion of vitamin D deficiency was 97.4%. Serum calcium, phosphorus and 25-（OH） D level of experimental group was significantly higher than those of the control group. In the small and large for gestational age group, vitamin D supplementation of 400 IU/d respectively increased mean 25- （OH） D levels from 23. 556 nmol/L,27. 771 nmol/L at birth to 27. 423 nmol/L,32. 198 nmol/L at discharge. Conclusion We concluded that low 25-（OH） D levels was an issue for preterm infants, warranting early nutritional intervention, a vitamin D intake of 400 IU daily increased target levels. It was an important measure of health support in preterm infants.