不同剂量维生素D对早产儿骨代谢指标的影响

Effects of Different Doses of Vitamin D on the Bone Metabolic Markers in Premature Infant

目的:探讨口服两种不同剂量维生素D对早产儿骨代谢等指标的影响和预防早产儿代谢性骨病(MBD)的效果。方法:将2019年3月至2020年11月本院80例早产儿按照随机数字表均分为对照组和观察组。2组均予肠内外营养、补充蛋白质、脂肪等,在此基础上对照组予维生素D 400 IU/d,观察组予维生素D 800 IU/d。观察2组干预前后生长指标、早产儿代谢性骨病(metabolic bone disease,MBD)发生率、血清骨代谢指标等。结果:生后第28天2组患儿血清25-羟维生素D[25(OH)D]、钙、碱性磷酸酶值(alkaline phosphatase,ALP)、体重、骨密度、身高呈升高趋势,血磷值呈降低趋势。观察组25(OH)D(61.97±10.23 vs 43.75±7.04)nmol/L,骨密度(2935.61±389.83 vs 2164.39±352.08)m/s、血清磷(2.08±0.24 vs 1.41±0.19)mmol/L高于对照组,ALP值(482.79±35.64 vs 563.59±24.37)IU/L、MBD发生率(5%vs 20%)低于对照组,差异有统计学意义(P<0.05)。结论:800IU/d维生素D较400 IU/d维生素D可有效改善早产儿钙磷代谢状态和骨代谢水平,促进骨密度增加,降低MBD发生率。

[Objective]To compare the effects of two different doses of vitamin D on the bone metabolic markers and preventing MBD in premature infant.[Method]From Mar 2019 to Nov 2020,80 premature infants were randomly divided into two groups according to the random number table.The two groups were given nutrition,protein,fat,etc.On this basis,the control group was given vitamin D 400 IU/d,while the study group was given vitamin D 800 IU/d.The growth index,MBD incidence rate,serum bone metabolism index were evaluated in the two groups before and after intervene.[Result]The 25(OH)D,Ca,ALP,body weight,bone mineral density and length levels showed an upward trend,while P level showed downward.The level of 25(OH)D(61.97±10.23 vs 43.75±7.04)nmol/L,BMD(2935.61±389.83 vs 2164.39±352.08)m/s,serum P(2.08±0.24 vs 1.41±0.19)mmol/L in the study group were higher than that in the control group,serum ALP(482.79±35.64 vs 563.59±24.37)IU/L,MBD incidence rate(5 vs 20%)in the study group were lower than that in the control group,the differences were statistically significant(P<0.05).[Conclusion]Compared to 400 IU/d vitamin D,800 IU/d vitamin D can effectively improve preterm infants’calcium phosphorus metabolism and bone metabolism,promoting bone mineral density growth,reducing the incidence rate of MBD.