早产儿支气管肺发育不良及远期肺功能与出生时维生素D水平的关系

A study on the correlations between bronchopulmonary dysplasia in preterm infants,long-term pulmonary function,and vitamin d levels at birth

目的分析早产儿出生时维生素D水平与支气管肺发育不良(BPD)及远期肺功能的关系。方法选取2018年6月至2020年3月本院新生儿重症监护室内的120例早产儿,检测所有早产儿血清维生素D水平,对所有早产儿于2岁时进行随访,检测其肺功能指标达峰时间比(TPTEF/TE)、达峰容积比(VPTEF/VE)及呼吸峰流速(PEF)水平。Spearman分析血清维生素D水平与BPD的关系,Pearson分析血清维生素D水平与2岁时肺功能指标TPTEF/TE、VPTEF/VE、PEF的关系。结果与非BPD组早产儿比较,BPD组早产儿血清维生素D水平明显降低(P<0.05)。不同BPD等级患儿血清维生素D水平差异有统计学意义(P<0.05),随着BPD病情严重程度增加,患儿血清维生素D水平逐步降低。与非BPD组早产儿比较,BPD组早产儿2岁时肺功能指标TPTEF/TE、VPTEF/VE、PEF均明显降低(P<0.05)。不同BPD等级患儿2岁时肺功能指标TPTEF/TE、VPTEF/VE、PEF均差异有统计学意义(P<0.05),随着BPD病情严重程度增加,患儿肺功能指标TPTEF/TE、VPTEF/VE、PEF逐步降低。早产儿血清维生素D水平与BPD呈明显负相关(r=-0.659,P<0.05)。早产儿血清维生素D水平与2岁时肺功能指标TPTEF/TE、VPTEF/TE、PEF均呈明显正相关(r=0.254、0.232、0.265,P<0.05)。结论早产儿出生时维生素D水平与BPD及远期肺功能均密切相关,早产儿出生时维生素D缺乏能够用于评估BPD发展进程并预测患儿的远期预后水平。

Objective To analyze the relationship between vitamin D levels at birth and the development of bron-chopulmonary dysplasia(BPD)and long-term pulmonary function in preterm infants.Methods A total of 120 preterm infants admitted to the neonatal intensive care unit(NICU)between June 2018 and March 2020 were included in this study.Serum vitamin D levels were measured in all preterm infants at birth.Follow-up assessments were conducted when the infants reached 2 years of age,during which pulmonary function parameters,including TPTEF/TE,VPTEF/VE,and PEF,were measured.Spearman correlation analysis was used to assess the relationship between serum vitamin D levels and the development of BPD,while Pearson correlation analysis was used to evaluate the association between serum vita-min D levels at birth and pulmonary function parameters at 2 years of age.Results Compared to preterm infants in the non-BPD group,those in the BPD group had significantly lower serum vitamin D levels(P<0.05).Serum vitamin D levels varied significantly among infants with different BPD severity levels(P<0.05),with progressively lower levels ob-served in more severe cases.At 2 years of age,preterm infants in the BPD group exhibited significantly lower pulmonary function parameters,including TPTEF/TE,VPTEF/VE,and PEF,compared to those in the non-BPD group(P<0.05).Significant differences in these pulmonary function parameters were also observed among infants with varying BPD severity levels(P<0.05),with greater disease severity corresponding to lower pulmonary function parameters.There was a significant negative correlation between serum vitamin D levels at birth and the development of BPD(r=-0.659,P<0.05).Moreover,serum vitamin D levels at birth were positively correlated with pulmonary function parameters at 2 years of age,including TPTEF/TE,VPTEF/TE,and PEF(r=0.254,0.232,0.265,P<0.05).Conclusion Serum vitamin D levels at birth are closely associated with the development of BPD and long-term pulmonary function in preterm infants.Vitamin D deficiency at birth can be used to assess the progression of BPD and predict the long-term prognosis of affected infants.