极低出生体重儿血清25-羟维生素D水平影响因素分析

Study on factors influencing 25-(OH)-D levels in infantwithvery low birth weight

目的通过对极低出生体重儿(VLBW)生后第22天血清25-羟维生素D[(25-(OH)-D]水平影响因素的分析,为VLBW代谢性骨病的防治提供依据。方法选取136例VLBW,测定其出生后第22天血清25-(OH)-D水平,将其分为正常组与不足组,对两组潜在的影响因素(包括胎龄,出生体重,出生第1天血清25-(OH)-D水平,营养方式,并发症,被动运动情况等)进行分析。结果共纳入VLBW136例,平均胎龄(30.47±1.92)周,平均出生体重(1272.35±112.32)g,生后第22天血清25-(OH)-D平均水平为(28.33±7.24)ng/ml,正常34.6%,不足65.4%。单因素分析显示:两组比较:胎龄,出生体重,生后第1天血清25-(OH)-D水平,静脉营养是否超过7天具有显著性差异(P<0.05)。多因素分析显示:胎龄、出生体重、生后第1天血清25-(OH)-D水平为VLBW生后22天血清25-(OH)-D水平达标的保护因素,而静脉营养时间超过7 d为生后22 d血清25-(OH)-D缺乏的危险因素。结论影响VLBW生后22 d血清25-(OH)-D水平的危险因素是:胎龄,出生体重,生后第1天血清25-(OH)-D水平,静脉营养超过7天。

Objective To analyze the factors influencing serum 25-hydroxyl vitamin D（25-（OH）-D） for infantswith very low birth weight（VLBW） at 22 days after birth,and to provide evidence for the prevention and treatment of VLBW metabolic bone disease. Methods 136 VLBW infants were admitted to our hospital NICU; these served as the sample population for our investigation.The VLBW infants were divided intonormal group and deficiency group by their serum 25-（OH）-D level at 22 days after birth. Potential factors influencing serum 25-（OH）-D levels were investigated to assess their impact（including gestational age,birth weight,day-1 post-delivery serum 25-（OH）-D level,nutrition,complications,passive movement,etc.）. Results The mean gestational age was（30. 47 ± 1. 92） weeks,and the mean birth weight was（1272. 35 ± 112. 32） g,the average level of serum 25-（OH）-D at 22 days after birth was（28. 33 ± 7. 24） ng/ml. The rate of vitamin D normal and deficiency were 34. 6% and 65. 4%. Single factor analysis showed that differences between the two groups in relation to gestational age,birth weight,day-1 post-delivery serum 25-（OH）-D level,parenteral nutrition more than 7 days were all statistically significantly（P〈0.05）. Multivariate non-conditional logistic regression analysis showed： gestational age,birth weight,day-1 post-delivery serum 25-（OH）-D level were the protective factors of serum 25-（OH）-D levels at day-22 post-delivery,and parenteral nutrition more than 7 days was a risk factor. Conclusion The statistically significant factors affecting serum 25-（OH）-D levels for day-22 post-delivery VLBW infants are gestational age,birth weight,day-1 post-delivery serum 25-（OH）-D level,and parenteral nutrition more than 7 days.