维生素D水平与足月新生儿早发型败血症的关系

Relationship between vitamin D levels and early-onset sepsis in full-term newbrons

目的检测足月新生儿及其母亲血清25-羟维生素D[25-(OH)D]水平,分析25-(OH)D与败血症的关系。方法选取2019年1—12月在昆明市儿童医院新生儿科住院诊断为早发型败血症(EOS)的足月新生儿52例为观察组,另选取同期在云南省第二人民医院分娩的健康足月新生儿50例为对照组。两组新生儿及其母亲均在产后7 d内采血进行25-(OH)D水平检测,比较两组新生儿及其母亲的血清25-(OH)D水平,同时检测血常规、超敏C-反应蛋白(hs-CRP)、降钙素原(PCT)及血培养结果。结果两组母亲分娩年龄和围生期合并症比较,差异均无统计学意义(P>0.05)。观察组患儿WBC、PCT及hs-CRP水平均高于对照组,血小板(PLT)水平低于对照组,差异均有统计学意义(均P<0.05),观察组新生儿和母亲血清25-(OH)D水平均低于对照组,差异均有统计学意义(均P<0.05)。两组新生儿和母亲血清25-(OH)D水平均呈正相关关系(观察组:r=0.967,P<0.05,对照组:r=0.719,P<0.05),观察组血清25-(OH)D与hs-CRP和PCT均呈负相关关系(r=-0.479、-0.412,均P<0.05),与WBC、PLT无明显相关性(r=-0.015、-0.063,均P>0.05)。结论维生素D缺乏与新生儿败血症可能存在相关性,推荐在母亲孕期补充足量的维生素D,降低EOS发病率。维生素D可能成为新生儿败血症治疗的辅助药物。

Objective To detect serum 25-hydroxyvitamin D[25-(OH)D]levels in full-term newbrons and their mothers,and to analyze the relationship between 25-(OH)D and sepsis.Methods A total of 52 full-term newbrons diagnosed with early-onset sepsis(EOS)who were hospitalized in the Department of Neonatology,Kunming Children's Hospital from January to December 2019 were selected as the observation group,and 50 healthy full-term newbrons who were delivered in the Second People's Hospital of Yunnan Province during the same period were selected as the control group.Blood samples were collected from the neonates and their mothers within 7 days after de⁃livery to detect the serum 25-(OH)D level.The serum 25-(OH)D level of the neonates and their mothers was compared between the two groups.Meanwhile,blood routine test,high-sensitivity C-reactive protein(hs-CRP),procalcitonin(PCT)and blood culture results were detected.Results There were no significant differences in maternal age at delivery and perinatal complications between the two groups(P>0.05).The WBC,PCT and hs-CRP levels of the observation group were higher than those of the control group,and the platelet(PLT)level was lower than that of the control group,and the differences were statistically significant(all P<0.05).The serum 25-(OH)D levels of newborns and mothers in the observation group were lower than those in the control group,and the differences were statistically significant(all P<0.05).The serum 25-(OH)D levels of newborns and mothers in the two groups were positively correlated(observation group:r=0.967,P<0.05,control group:r=0.719,P<0.05).In the observation group,serum 25-(OH)D was nega⁃tively correlated with hs-CRP and PCT(r=-0.479,-0.412,all P<0.05),but not significantly correlated with WBC and PLT(r=-0.015,-0.063,all P>0.05).Conclusion There may be the correlation between vitamin D deficiency and neonatal sepsis.It was recom⁃mended to supplement sufficient vitamin D during pregnancy to reduce the incidence of EOS.Vitamin D may become an adjuvant drug for the treatment of neonatal sepsis.