胎膜早破新生儿脐血25羟维生素D水平及与早发型败血症的关系

Relationship between 25(OH)D level in cord blood with premature rupture of membrane and early onset neonatal sepsis

目的探讨胎膜早破新生儿脐血25羟维生素D[25(OH)D]水平,及其与新生儿早发型败血症(early⁃onset sepsis,EOS)的关系。方法选择2018年1-12月河北医科大学第一医院产科分娩胎膜早破≥24 h的足月新生儿80例,分为EOS组24例,非EOS组56例,并将同期出生的健康足月新生儿30例为对照组。三组均于生后立即采集脐静脉血测定25(OH)D和降钙素原(procalcitonin,PCT)。结果非EOS组、EOS组脐血25(OH)D水平与对照组比较,差异均有统计学意义(均P<0.05),EOS组脐血25(OH)D水平与非EOS组比较,差异有统计学意义(P<0.05)。EOS组新生儿脐血25(OH)D与PCT呈负相关(r=-0.511,P<0.05)。EOS组、非EOS组和对照组三组脐血25(OH)D缺乏率比较,差异有统计学意义(χ2=17.738,P<0.01),其中,EOS组、非EOS组与对照组比较,差异均有统计学意义(均P<0.01)。结论低水平的脐血25(OH)D与EOS有相关性,监测脐血25(OH)D水平,预防维生素D缺乏,可降低早发型败血症的风险。

Objective To investigatethe level of vitamin D in cord Blood with PROM and its relationship with early onset neonatal sepsis.Methods 80 cases of full⁃term neonates with PROM who were delivered in the maternity ward,the First Hospital of Hebei Medical University were selected from January 2018 to December 2018.They were divided into the early onset sepsis(EOS)group of 24 cases and the non EOS group of 56 cases.30 healthy full⁃term neonates born in the same period were selected as the control group.The cord blood of vitamin D levels were measured with high performance liquid chromatography tandem mass spectrometry.The cord blood of PCT levels were measured with micromagnetic grain of chemiluminescence immunoassay.Results The levels of cord blood 25(OH)D in non⁃EOS and EOS group were statistically significant compared with those in the control group(P<0.05,P<0.01).The 25(OH)D levels of cord blood in the EOS group were statistically significant compared with the non⁃EOS group(P<0.05).Cord blood 25(OH)D was negatively correlated with PCT in EOS group(r=-0.511,P<0.05).The cord blood 25(OH)D deficiency rate was 91.7%in the EOS group,73.2%in the non EOS group,40%in the control group,and statistically significant in the three groups(χ2=17.738,P<0.01).EOS group and non EOS group were statistically significant compared with the control group(all P<0.01).Conclusions The low level of cord blood 25(OH)D has a correlation with early onset neonatal sepsis.