不同剂量维生素D补充在早产儿中的应用研究

Application of different doses of vitamin D supplementation in premature infants

目的评估不同剂量维生素D补充对胎龄≤34周早产儿出院时维生素D水平的影响,为早产儿生后合理补充维生素D提供依据。方法选择2019年1月—2020年6月在博罗县妇幼保健计划生育服务中心出生的胎龄≤34周早产儿67例,在完全肠内喂养后开始口服维生素D,并随机分为维生素D低剂量组(n=32)和高剂量组(n=35),比较两组患儿出院时25(OH)D水平、维生素D缺乏/不足的比例及相关不良反应发生率。结果两组患儿出生时脐带血25(OH)D水平、维生素D缺乏/不足发生率比较,差异无统计学意义(P>0.05);出院时高剂量组血清25(OH)D水平明显高于低剂量组、维生素D缺乏/不足发生率明显低于低剂量组(t=2.872、χ^(2)=4.189,P<0.05),但高剂量组出院时维生素D缺乏/不足发生率仍为28.6%。结论对于胎龄≤34周的早产儿,给予补充维生素D 800 U/d可明显改善患儿出院时维生素D缺乏或不足的情况,但对于胎龄更小、出生体重更低的超低出生体重儿,可能需要更大剂量的维生素D补充。

Objective To evaluate the effect of different doses of vitamin D supplementation on vitamin D level of preterm infants with gestational age≤34 weeks at discharge,in order to provide evidence for the post-natal vitamin supplementation of premature infants.Methods A total of 67 premature infants with gestational age 34 weeks or less in Boluo Maternal and Child Care Hospital from January 2019 and June 2020 were randomly divided into low-dose group(32 cases)and high-dose group(n=35)after full enteral feeding.Then the discharge level of 25(OH)D,vitamin D insufficiency and related adverse reactions were compared.Results There was no statistically significant difference in the level of 25(OH)D of umbilical cord blood at birth between low-dose group and high-dose group(P>0.05).The serum 25(OH)D level of infants in the high-dose group was significantly higher than that of the low-dose group(t=2.872,P<0.05).The incidence of vitamin D deficiency/insufficiency at discharge in the high-dose group was significantly lower than that in the low-dose group(χ^(2)=4.189,P<0.05).However,the incidence of vitamin D deficiency/deficiency in the high-dose group still reached to 28.6%.Conclusions For premature infants with gestational age≤34 weeks,supplementing vitamin D at 800 U/d can significantly improve the deficiency or insufficiency of vitamin D at discharge.However,for ultra-low birthweight infants with lower gestational age and lower birth weight,a larger dose of vitamin D supplementation may be required.