基于倾向性评分匹配的血清维生素A、D、E水平与早产儿早发型败血症的关系

Relationship between serum vitamin A,D,and E levels with early-onset sepsis in preterm infants based on propensity score matching

目的探讨血清维生素A(Vit A)、Vit D和Vit E水平与早产儿早发型败血症(EOS)的关系。方法选取2019年1月至2020年12月浙江省嘉兴市妇幼保健院收治的54例诊断为EOS早产儿为EOS组,同期未发生败血症的127名早产儿为对照组。采用1∶1倾向性评分匹配(PSM)平衡组间混杂因素,比较组间Vit A、Vit D和Vit E水平及缺乏率,logistic回归分析早产儿EOS与维生素水平的关系。结果PSM后共有33对早产儿匹配成功。两组血清Vit A、Vit E水平比较,差异无统计学意义(P>0.05);EOS组血清25(OH)Vit D水平低于对照组,差异有统计学意义(P<0.05)。两组血清Vit A、Vit E缺乏率比较,差异无统计学意义(P>0.05);EOS组血清25(OH)Vit D缺乏率高于对照组,差异有统计学意义(P<0.05)。logistic回归分析显示,高水平25(OH)Vit D是早产儿EOS发生的保护因素(OR=0.867,95%CI:0.793~0.947,P<0.05)。结论血清Vit D水平是早产儿EOS发生的重要因素,但并未发现Vit A、Vit E与早产儿EOS有关。

Objective To investigate the relationship between serum vitamin A(Vit A),Vit D and Vit E levels with early-onset sepsis(EOS)in preterm infants.Methods Fifty-four preterm infants diagnosed with EOS in Jiaxing Maternal and Child Health Hospital of Zhejiang Province from January 2019 to December 2020 were selected as the EOS group,127 premature infants without sepsis during the same period were the control group.The 1∶1 propensity score matching(PSM)was used to balance the confounding factors between groups,Vit A,Vit D,and Vit E levels and deficiency rates were compared between groups,logistic regression analysis was used to evaluate the relationship between EOS and vitamin levels in premature infants.Results A total of 33 pairs of premature infants were successfully matched after PSM.There was no significant difference in serum Vit A and Vit E levels between the two groups(P>0.05);the serum 25(OH)Vit D level in EOS group was lower than that in control group,and the difference was statistically significant(P<0.05).There was no significant difference in serum Vit A and Vit E deficiency rates between the two groups(P>0.05);the serum 25(OH)Vit D deficiency rate in EOS group was higher than that in control group,and the difference was statistically significant(P<0.05).Logistic regression analysis showed that high level of 25(OH)Vit D was an protective factor for the occurrence of EOS in premature infants(OR=0.867,95%CI:0.793-0.947,P<0.05).Conclusion Serum Vit D level was an important factor in the occurrence of EOS in premature infants,but Vit A and Vit E were not found to be associated with EOS in premature infants.