补充维生素D对婴儿肝炎综合征生化指标及预后的影响

Effect of vitamin D supplementation on biochemical indexes and prognosis of infantile hepatitis syndrome

目的探讨补充维生素D对婴儿肝炎综合征(IHS)生化指标及预后的影响。方法选择2016年11月至2019年11月郴州市第一人民医院收治的112例IHS患儿,按照随机数字表法分为两组,各56例,其中对照组采取常规治疗,观察组在常规治疗基础上补充维生素D,均持续治疗10 d。观察两组临床疗效,比较两组治疗前后血清直接胆红素(DBil)、总胆红素(TBil)、谷氨酰转肽酶(γ-GT)、丙氨酸氨基转移酶(ALT)水平,分析两组治疗前后血清25-羟维生素D3[25(OH)D3]、单核细胞核因子κB(NF-κB)、肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)水平,并观察两组患儿不良反应发生情况。结果观察组总有效率为92.86%,显著高于对照组的75.00%(P<0.05)。观察组患儿治疗后血清DBil、TBil、γ-GT、ALT显著低于治疗前及对照组治疗后(P<0.05)。观察组患儿治疗后血清25(OH)D3显著高于治疗前及对照组治疗后(P<0.05),NF-κB、TNF-α、IL-6显著低于治疗前及对照组治疗后(P<0.05)。治疗期间,两组所有患儿未发现烦躁不安、厌食、恶心、发热、心律不齐等不良反应。结论 IHS患儿补充维生素D疗效确切,能有效缓解炎性反应及肝损伤,且安全性较好,临床应引起足够重视。

Objective To explore the effect of vitamin D supplementation on biochemical indexes and prognosis of infant hepatitis syndrome(IHS).Methods 112 children with IHS admitted to our hospital from November 2016 to November 2019 were divided into two groups according to the random number table method,56 cases in each group,of which the control group was treated with routine treatment,and the observation group was supplemented with vitamin D on the basis of routine treatment,all of which lasted for 10 days.We observed clinical curative effect of two groups,and compared serum direct bilirubin(DBil),total bilirubin(TBil),glutamyl transpeptidase(γ-GT),alanine aminotransferase(ALT)level of two groups before and after treatment,serum 25-hydroxyl vitamin D3[25(OH)D3],monocyte nuclear factor kappa B(NF-κB)predominate,tumor necrosis factor alpha(TNF-α),interleukin 6(IL-6)levels of two groups before and after treatment were analyzed,and we observed adverse reactions of two groups of children.Results The total effective rate of the observation group was 92.86%,which was significantly higher than 75.00%of the control group(P<0.05).The serum levels of DBil,TBil,γ-GT and ALT in the observation group were significantly lower than those before and after treatment in the control group(P<0.05).The serum25(OH)D3 in the observation group was significantly higher than that before and after treatment in the control group(P<0.05),and NF-κB,TNF-α,IL-6 were significantly lower than that before and after treatment in the control group(P<0.05).During the treatment period,there were no dysphoria,anorexia,nausea,fever,arrhythmia and other adverse reactions in all children in the two groups.Conclusion Vitamin D supplementation for children with IHS had definite effect,could effectively alleviate inflammatory reaction and liver injury,and with good safety,which should be paid enough attention in clinical practice.