不同胎龄早产儿血清25羟维生素D水平及其与骨定量超声值的关系

Serum level of 25 - hydroxyvitamin D and its correlation with bone quantitative ultrasound measurement in different gestational age premature infants

目的探讨不同胎龄早产儿维生素D状况，并评价其与骨定量超声值的关系。方法采用化学发光免疫分析方法测定2013年3月至2014年3月在广州市花都区妇幼保健院出生的早产儿血清25羟维生素D[25-（OH）D]水平，并应用Omnisense定量超声仪测量其左侧胫骨中段骨超声传播速度（SOS）。根据胎龄将早产儿分为A组（胎龄28～32周）、B组（胎龄32＋1～34周）、C组（胎龄34＋1～36＋6周），比较3组间25-（OH）D水平和SOS值，并分析25-（OH）D水平与SOS值之间的相关性。结果A、B、C组早产儿血清25-（OH）D水平分别为（41.65±21.15） nmol/L、（47.15±19.78） nmol/L和（49.35±19.93） nmol/L，3组间比较差异有统计学意义（F＝4.441，P＝0.012）。3组早产儿维生素D充足与非充足（非充足包括不足、缺乏）的比率进行比较，差异具有统计学意义（χ2＝11.38，P＝0.023）。A、B、C组早产儿骨定量SOS值分别为（2 787.85±123.01） m/s、（2 865.12±129.44） m/s、（2 908.59±124.01） m/s，3组间比较差异有统计学意义（F＝28.716，P＝0.000）。早产儿25-（OH）D与SOS具有正相关（r＝0.084，P＝0.024）。结论早产儿普遍存在维生素D水平不足或缺乏，胎龄越小，发生率越高。骨定量超声值与血清维生素D水平呈正相关，二者均随着早产儿胎龄的增加而增加。

Objective To determine the amount of serum Vitamin D in premature infants, and to investigate its correlation with bone quantitative ultrasound measurement, Methods The serum of premature infants born between 2013 March and 2014 March in the Maternal and Children Health Hospital of Huadu District in Guangzhou were col- lected, and serum 25 - hydroxyvitamin D [ 25 - （OH）D ] level was measured by using chemiluminescence immunoassay,while Omnisense quantitative ultrasound was used to measure bone speed of sound（SOS） in the middle area of the left tibia. According to gestational age, the participants were divided into A, B and C groups （ 28 - 32 weeks, 32 ＋ 1 _ 34 weeks ,34 ＋1 -36 ＋6 weeks, respectively）. The levels of 25 - （OH）D and SOS were compared and the correlation between them was analyzed. Results The amount of 25 - （OH） D of the 3 groups was （41.65 ± 21. 15 ） nmol/L, （47. 15 ±19.78） nmol/L, and （49.35 ±19.93 ） nmol/L, respectively, and the differences among the 3 groups were statistically significant （ F = 4. 441 ,P = 0. 012）. The ratio of vitamin D abundant or not （ insufficiency including defi- ciency and lack） in preterm among the 3 groups were compared, and the differences among the 3 groups were statistical- ly2 slgmfieant（X2= 11.38,P = 0. 023）. SOS of the 3 groups were （2 787.85 ± 123.01 ） m/s, （2 865.12± 129.44） m/s and （2 908.59 ± 124.01 ） m/s, respectively, and the differences among the 3 groups were statistically significant （ F = 28.716, P = 0. 000）. There was a positive correlation between 25 - （OH） D and SOS （ r = 0. 084, P = 0. 024 ）. Conclusions Level of Vitamin D in premature infants is generally inadequate. The smaller the gestational age, the higher the oeeurrenee rate. Vitamin D levels and SOS are significantly positively correlated, and both of them increase with gestational age.