200例住院新生儿25-羟基维生素D水平的变化对疾病诊断的影响

Influence of Changes in Levels of 25-hydroxyvitamin D on Disease Diagnosis of 200 Hospitalized Newborns

目的:分析新生儿(早产儿及足月儿)住院期间血清25-羟基维生素D值的变化对疾病诊断的相关性。方法:选取徐州市妇幼保健院新生儿科2016年1月—2017年12月期间的住院患儿200例资料,剔除重度窒息、贫血、先天遗传代谢性疾病患儿资料,根据监测结果比较新生儿的25-羟基维生素D测得值的变化情况对新生儿相关因素的影响。结果:监测200例新生儿(其中早产儿105例占52.50%,足月儿95例占47.50%);足月儿血清25-羟基维生素D测得值高于早产儿(P<0.05);新生儿男性组和女性组之间25-羟基维生素D测得值经组间比较其差异无统计学意义(P>0.05);新生儿极低出生体质量儿组、低出生体质量儿组、正常出生体质量儿组和巨大儿组之间血清25-羟基维生素D测得值经组间比较其差异无统计学意义(P>0.05),但极低出生体质量儿组和巨大儿组血清25-羟基维生素D测得值相对较低;按照疾病分组发现,正常足月儿、新生儿胎粪吸入综合征组患儿血清25-羟基维生素D测得值明显高于其他组(P<0.05);此外,新生儿血清25-羟基维生素D测得值在秋季为最高,冬季为最低,其中夏、秋季明显高于春冬季,经组间比较其差异有统计学意义(F=8.206,P<0.05)。结论:早产儿比足月儿更易缺乏25-羟基维生素D;不同性别、不同出生体质量的新生儿血清25-羟基维生素D水平各不相同;不同疾病、不同出生季节的新生儿血清25-羟基维生素D水平也不相同,建议用维生素D 2 000 U/d或50 000 U/周,血清中维生素D 30μg/L以上,然后再以正常婴幼儿补充的量维持。

Objective： To analyze the changes of the serum 25-hydroxyvitamin D levels during hospitalization in newborns（preterm and full-term children）, and to explore the vitamin D levels and related influencing factors. Methods： The data of hospitalized children from January 2016 to December 2017 in the Department of Neonatology of Xuzhou Maternal and Child Health Hospital were collected excluding those with severe asphyxia, anemia, and congenital genetic metabolic diseases serum 25-hydroxyvitamin D levels were measured using immunochromatography. Based on the monitoring results, the neonatal 25-hydroxyvitamin D values were compared and the effects of related factors were also compared. Results： A total of 200 neonates were monitored（among them, 105 premature infants accounted for 52.50% and 95 full-term infants accounted for 47.50%）. The serum 25-hydroxyvitamin D values in term infants were higher than those in preterm infants（P〈0.05）. There was no significant difference in the 25-hydroxyvitamin D values between the neonatal male and female groups. The serum 25-hydroxyvitamin D values in neonates with very low birth body mass infants, low birth body mass infants, normal birth body mass infants and macrosomia infants were compared（P〉0.05）, and the difference was not statistically significant, but the extremely low birth body mass infant group and the macrosomia group were relatively low.According to the disease group, the serum 25-hydroxyvitamin D values in normal term infants and neonatal meconium aspiration syndrome group were significantly higher than those in other groups（P〈0.05）, and the difference was statistically significant. In addition, serum 25-hydroxyvitamin D values were the highest in autumn and lowest in winter, and were significantly higher in summer and autumn than in spring and winter. The difference was statistically significant（F=8.206, P〈0.05）. Conclusion： Preterm infants are more prone to vitamin D deficiency than full-term infants. The levels of serum 25-hydroxyvitamin D in newborns of different genders and different birth weights are different, and the difference is not statistically significant. The levels of serum 25-hydroxyvitamin D in newborns with different diseases and different birth seasons are different. It is recommended to use vitamin D 2 000 U/d or 50 000 U/week, and Vitamin D in the serum is greater than 30μg/L, which is then maintained with normal amounts for infants.