维生素D补充对早产儿骨代谢及体液免疫功能的影响

Effect of vitamin D supplementation on the prevention of metabolic bone disease and humoral immunefunction in premature infants

目的探讨维生素D补充对早产儿骨代谢及体液免疫功能的影响。方法根据随机数字表法,将在2021年1月至2023年1月于许昌市妇幼保健院出生的63例早产儿分为对照组(31例)和观察组(32例)。对照组给予常规吸氧、保暖等治疗,并使用早产儿专属的配方奶粉喂养;观察组在保持上述基础治疗的同时联合维生素D补充治疗。比较2组治疗前后的生长发育指标、骨代谢指标、免疫球蛋白水平及T细胞亚群。结果经治疗2组早产儿身长、体质量、骨密度均增加,且观察组[(47±4)cm、(3.2±0.7)kg、(2890±344)g/cm^(2)]较对照组[(45±3)cm、(2.8±0.5)kg、(2315±319)g/cm^(2)]增幅更大(P<0.05)。对照组早产儿血清磷、血清钙、血清25-羟维生素D、血清碱性磷酸酶水平治疗前后比较差异均无统计学意义(P>0.05);观察组治疗后早产儿的血清磷水平(1.89±0.09)mmol/L降低,且低于对照组(2.07±0.10)mmol/L;血清钙、血清25-羟维生素D、血清碱性磷酸酶[(2.25±0.27)mmol/L、(32±6)nmol/L、(437±35)U/L]均升高,且高于对照组[(2.06±0.12)mmol/L、(26±4)nmol/L、(266±45)U/L](P<0.05)。2组早产儿治疗前后免疫球蛋白A、免疫球蛋白M、免疫球蛋白G水平比较差异均无统计学意义(P>0.05)。对照组早产儿CD3^(+)、CD4^(+)、CD8^(+)水平治疗前后比较均差异无统计学意义(P>0.05);治疗后观察组早产儿的CD3^(+)、CD4^(+)、CD8^(+)水平均升高,且CD3^(+)、CD4^(+)水平[(70±5)%、(40±3)%]高于对照组[(64±4)%、(36±3)%](P<0.05);但2组CD8^(+)水平比较差异无统计学意义(P>0.05)。结论维生素D补充可有效促进早产儿生长发育及骨密度的增加,改善早产儿的骨代谢水平与钙磷代谢,增强细胞免疫功能,但对免疫球蛋白水平的影响有待进一步观察。

Objective To explore the effect of vitamin D supplementation on the prevention of metabolic bone disease and humoral immune function in premature infants.Methods According to the random number table method,a total of 63 newborns born between January 2021 and January 2023 at Xuchang Maternal and Child Health Hospital were divided into a control group(31 cases)and an observation group(32 cases).Premature infants in the control group were given conventional oxygen inhalation,warmth retention and other treatments,and were fed with formula milk powder specifically designed for premature infants.While Premature infants in the observation group received vitamin D supplementation treatment in addition to the above basic treatments.The growth and development indicators,bone metabolism indicators,immunoglobulin levels,and T lymphocyte subsets before and after treatment were compared between two groups.Results After treatment,the length,weight,and bone density of both groups of newborns increased,and the observation group[(47±4)cm,(3.2±0.7)kg,(2890±344)g/cm^(2)]showed a greater increase than the control group[(45±3)cm,(2.8±0.5)kg,(2315±319)g/cm^(2)](P<0.05).There was no significant difference in the levels of serum phosphorus,serum calcium,serum 25 hydroxyvitamin D,and serum alkaline phosphatase in the control group of newborns before and after treatment(P>0.05).After treatment,the serum phosphorus level of newborns in the observation group decreased significantly(1.89±0.09)mmol/L,and was lower than that in the control group(2.07±0.10)mmol/L;However,serum calcium,serum 25 hydroxyvitamin D,and serum alkaline phosphatase levels[(2.25±0.27)mmol/L,(32±6)nmol/L,(437±35)U/L]were significantly increased,and higher than the control group[(2.06±0.12)mmol/L,(26±4)nmol/L,(266±45)U/L](P<0.05).There was no statistically significant difference in the levels of immunoglobulin A,immunoglobulin M,and immunoglobulin G between the two groups of newborns before and after treatment(P>0.05).There was no significant difference in the levels of CD3^(+), CD4^(+), and CD8^(+) among newborns in the control group before and after treatment(P>0.05). Aftertreatment, the levels of CD3^(+), CD4^(+), and CD8^(+) in the observation group all increased, and the levels of CD3^(+) andCD4^(+)[(70±5)%, (40±3)%] were significantly higher than those in the control group [(64±4)%, (36±3)%] (P<0.05);However, there was no significant difference in CD8^(+) levels between the two groups (P>0.05). Conclusion VitaminD supplementation can effectively promote the growth and development of premature infants, increase bonedensity, improve bone metabolism and calcium phosphorus metabolism, enhance cellular immune function, reducethe occurrence of metabolic bone diseases, and improve the prognosis of premature infants. However, the impacton immunoglobulin levels has not been effectively confirmed.