维生素D缺乏与早产儿坏死性小肠结肠炎的相关性

Relationship between vitamin D deficiency and necrotizing enterocolitis in preterm infants

目的评估维生素D水平对早产儿坏死性小肠结肠炎(NEC)的影响。方法选取2016年1~12月于生后2 h内入新生儿科住院治疗的胎龄<36周的早产儿429例为研究对象,依据患儿是否发生NEC,将429例患儿分为NEC组(n=22)和非NEC组(n=407)。采集早产儿及其母亲入院时外周静脉血进行25-羟基维生素D(25-OHD)水平检测,比较两组早产儿和母亲血清25-OHD水平,Pearson相关分析早产儿和母亲血清25-OHD水平相关性,比较两组早产儿维生素D缺乏情况,单因素logistic回归分析早产儿NEC影响因素。结果 NEC组母亲和早产儿血清25-OHD水平均显著低于非NEC组(P<0.001)。两组母亲和早产儿之间血清25-OHD水平均呈正向关(P<0.001)。非NEC组与NEC组早产儿维生素D水平在正常、不足、缺乏、严重缺乏等状况的分布上比较差异有统计学意义(P<0.001)。单因素logistic回归分析结果显示:胎龄、出生体重、母亲和早产儿25-OHD水平、机械通气持续时间、用氧持续时间和住院时间可能是NEC发生的影响因素(P<0.05)。结论母亲和早产儿低血清25-OHD水平与早产儿NEC的发生可能具有相关性,提示母孕期补充维生素D对于预防早产儿NEC的发生有重要意义。

Objective To evaluate the relationship of vitamin D level with the development of necrotizing enterocolitis （NEC） in preterm infants.Methods A total of 429 preterm infants with a gestational age of36 weeks,who were admitted to the department of neonatology within 2 hours after birth between January and December,2016,were enrolled in the study.According to whether these infants developed NEC,the 429 subjects were divided into NEC group（n=22）and non-NEC group（n=407）.Peripheral venous blood was collected from these preterm infants and their mothers at admission to measure the level of 25-hydroxyvitamin D（25-OHD）.The two groups were compared in terms of the serum 25-OHD levels of preterm infants and their mothers.Pearson correlation analysis was used to investigate the correlation between the serum 25-OHD levels of preterm infants and their mothers.The distribution of vitamin D levels in preterm infants was compared between the two groups.The univariate logistic regression analysis was used to determine the risk factors for NEC in preterm infants.Results The serum 25-OHD levels of preterm infants and their mothers in the NEC group were significantly lower than in the non-NEC group （P0.001）.In both groups,the serum 25-OHD levels of mothers and preterm infants were positively correlated with each other （P0.001）.The distribution of vitamin D levels（normal vitamin D level,low vitamin D level,vitamin D deficiency,and severe vitamin D deficiency）was significantly different between the NEC and non-NEC groups （P0.001）.The univariate logistic regression analysis showed that gestational age,birth weight,25-OHD levels of preterm infants and their mothers,the duration of mechanical ventilation,the duration of oxygen inhalation,and the length of hospital stay were associated with the development of NEC （P〈0.05）.Conclusions The serum 25-OHD levels of preterm infants and their mothers may be related to the development of NEC in preterm infants,suggesting that vitamin D supplementation during pregnancy is important for preventing the development of NEC in preterm infants.