支气管肺发育不良患儿血清25羟维生素D_(3)水平与潮气呼吸肺功能及呼出气一氧化氮的相关性研究

Study on the correlation between serum 25-hydroxyvitamin D_(3)level and tidal respiratory pulmonary function and exhaled nitric oxide in children with bronchopulmonary dysplasia

目的探讨支气管肺发育不良(BPD)患儿血清25-羟维生素D_(3)[25(OH)D_(3)]水平与潮气呼吸肺功能及呼出气一氧化氮(FeNO)的关系;评估早期血清25(OH)D_(3)水平反映BPD患儿远期潮气呼吸肺功能及FeNO的价值。方法选取2020年8月至2022年8月江苏省苏北人民医院新生儿重症监护病房(NICU)收治的早产儿128例,其中诊断BPD 48例,根据出生后3天血清25(OH)D_(3)水平将BPD患儿分为维生素D充足组(6例)、维生素D不足组(18例)和维生素D缺乏组(24例),于纠正胎龄40周时行潮气呼吸肺功能及FeNO测定,比较3组患儿潮气呼吸肺功能及FeNO;采用Spearman相关性检验,分析BPD患儿血清25(OH)D_(3)水平与潮气呼吸肺功能及FeNO的相关性。结果①BPD组患儿血清25(OH)D_(3)水平显著低于非BPD组,差异有统计学意义(t=-5.688,P<0.05);BPD组的维生素D不足、缺乏比例均高于非BPD组,而维生素D充足比例则低于非BPD组,差异有统计学意义(χ^(2)值分别为8.464、10.291、30.476,P<0.05)。②BPD患儿维生素D充足组、维生素D不足组、维生素D缺乏组间潮气呼吸肺功能指标(TPTEF/TE、VPEF/VE)差异有统计学意义(H值分别为25.094、16.392,P<0.05);FeNO差异有统计学意义(F=28.686,P<0.05)。③BPD组患儿血清25(OH)D_(3)水平与潮气呼吸肺功能指标(TPTEF/TE、VPEF/VE)均呈显著正相关(r值分别为0.921、0.806,P<0.05);而与FeNO呈显著负相关(r=-0.749,P<0.05)。结论早期血清25(OH)D_(3)水平能有效评估BPD患儿远期潮气呼吸肺功能及FeNO,具有一定的临床指导价值。

Objective To explore the relationship between serum 25-hydroxyvitamin D_(3)[25(OH)D_(3)]levels and tidal breathing pulmonary function and fractional exhaled nitric oxide(FeNO)in children with bronchopulmonary dysplasia(BPD).To assess the value of early serum 25(OH)D_(3)levels in reflecting the tidal breathing pulmonary function and FeNO in children with BPD in the long term.Methods A total of 128 preterm infants admitted to the neonatal intensive care unit(NICU)of Subei People's Hospital of Jiangsu province from August 2020 to August 2022 were selected,of which 48 were diagnosed with BPD,and the BPD children were divided into the vitamin D-sufficient group(n=6),the vitamin D-insufficient group(n=18),and the vitamin D-deficient group(n=24)according to the serum 25(OH)D_(3)level at the third day after birth.tidal breathing pulmonary function and FeNO were measured at 40 weeks of corrected gestational age,and tidal breathing pulmonary function and FeNO were compared among the three groups.The correlation between serum 25(OH)D_(3)level and tidal breathing pulmonary function and FeNO in BPD children was analysed by Spearman's correlation test.Results①The serum 25(OH)D_(3)level of children in the BPD group was significantly lower than that in the non-BPD group,with a statistically significant differences(t=-5.688,P<0.05).The proportion of vitamin D insufficiency and deficiency in the BPD group was higher than that of the non-BPD group,while the proportion of vitamin D sufficiency was lower than that of the non-BPD group,with statistically significant differences(χ^(2)=8.464,10.291 and 30.476,respectively,all P<0.05).②The differences in tidal breathing pulmonary function indices(TPTEF/TE,VPEF/VE)among the vitamin D adequate,vitamin D insufficient,and vitamin D deficient groups of children with BPD were statistically significant(H=25.094 and 16.392,respectively,all P<0.05).The difference in FeNO was statistically significant(F=28.686,P<0.05).The higher the serum 25(OH)D_(3)levels were higher,TPTEF/TE and VPEF/VE were higher,and FeNO was lower.③The serum 25(OH)D_(3)levels of children in the BPD group were significantly positively correlated with the tidal breathing pulmonary function indexes(TPTEF/TE,VPEF/VE)(r=0.921 and 0.806,respectively,all P<0.05),while they were significantly negatively correlated with FeNO(r=-0.749,P<0.05).Conclusion Early serum 25-hydroxyvitamin D_(3)level can effectively evaluate tidal breathing lung function and FeNO in children with BPD,which has certain clinical application value.