维生素D不同给药时间对极低出生体质量预防早产儿支气管肺发育不良的效果

Comparison of therapeutic effects of vitamin D on bronchopulmonary dysplasia in very low birth weight preterm infants

目的分析极低出生体质量早产儿中维生素D不同给药时间对支气管肺发育的疗效,探讨维生素D的最佳给药时间,以提高疗效,改善患儿预后。方法选择湖南省妇幼保健院新生儿科2018年11月—2020年6月的68例极低出生体质量早产儿为研究对象,所有早产儿均予以维生素D防治支气管肺发育不良,根据维生素D不同给药时间将其分为A组与B组,各34例,A组于出生后3天给予800单位维生素D,B组于出生后1周给予800单位维生素D,比较两组早产儿的支气管肺发育不良发生率、呼吸机使用时间与吸氧时间、血清25羟维生素D3[25(OH)D3]与血浆sNGAL水平、免疫功能指标[免疫球蛋白(IgA)、IgG、Ig M]、炎性因子水平[白细胞介素-6(IL-6)、IL-8、肿瘤坏死因子–α(TNF-α)]。结果 A组早产儿的支气管肺发育不良发生率低于B组(P<0.05);A组早产儿的呼吸机使用时间与吸氧时间均短于B组(P<0.05);A组早产儿治疗后的血清25(OH)D3水平高于B组,血浆s NGAL水平低于B组(P<0.05);A组早产儿治疗后的免疫功能指标优于B组(P<0.05);A组早产儿治疗后的炎性因子水平优于B组(P<0.05)。结论极低出生体质量早产儿出生后3天应用维生素D防治支气管肺发育不良的临床效果优于出生后1周给药,能明显降低支气管肺发育不良的发生率,且能缩短呼吸机使用时间与吸氧时间,改善血清25(OH)D3与血浆s NGAL水平,且能在一定程度上提高早产儿的免疫功能,减轻炎性反应。

Objective To compare and analyze the effect of different administration time of vitamin D on bronchopulmonary dysplasia in very low birth weight premature infants, and to explore the optimal administration time of vitamin D, so as to improve the curative effect and prognosis of children. Methods Sixty-eight cases of very low birth weight premature infants in our hospital from November 2018 to June 2020 were recruited. All preterm infants were given vitamin D to prevent bronchopulmonary dysplasia. According to the different administration time of vitamin D, they were divided into group A and group B with 34 cases in each group. Group A was given 800 units of vitamin D 3 days after birth, and group B was given 800 units of vitamin D 1 week after birth. The incidence of bronchopulmonary dysplasia, duration of ventilator use and oxygen inhalation, serum 25(OH) D3 and plasma sngal levels, immune function indexes(IgA, IgG and IgM), levels of inflammatory factors(IL-6, IL-8 and TNF-α). Results The incidence of bronchopulmonary dysplasia in group A was lower than that in group B(P<0.05);the duration of ventilator and oxygen inhalation in group A was shorter than that in group B(P<0.05);the serum 25(OH)D3 level of group A after treatment was higher than that of group B, and the plasma sngal level was lower than that of group B(P<0.05);the immune function index of group A after treatment was better than that of group B(P<0.05);the inflammation of group A after treatment was better than that of group B(P<0.05). The level of sex factor in group B was better than that in group B(P<0.05). Conclusion The clinical effect of vitamin D on the prevention and treatment of bronchopulmonary dysplasia in very low birth weight premature infants is better than that in one week after birth, which can significantly reduce the incidence of bronchopulmonary dysplasia, shorten the time of ventilator use and oxygen inhalation, improve the level of serum 25(OH)D3 and plasma sngal, and improve the immune function of preterm infants to a certain extent mild inflammatory reaction, worthy of clinical promotion and application.