新生儿肺炎血清25-羟维生素D水平检测及对其预后的预测价值

Detection of serological indicators in neonatal pneumonia and its predictive value for prognosis

目的探讨血清25羟维生素D[25(OH)D]水平与新生儿肺炎病情严重程度的关系及对预后的预测价值。方法选取2021年6月至2023年6月山东大学齐鲁医院德州医院收治的264例诊断为新生儿肺炎患儿为研究对象,根据肺炎病情严重程度分为重症肺炎组87例,轻症肺炎组177例。比较两组基线资料及血清25(OH)D水平;采用多因素Logistic回归分析新生儿肺炎病情严重程度的影响因素;采用ROC曲线分析血清25(OH)D水平对新生儿肺炎病情严重程度及预后的预测价值。结果重症肺炎组患儿血清25(OH)D、血钙、血清总蛋白水平均低于轻症肺炎组(P<0.05),碱性磷酸酶高于轻症组,重症组胎龄、出生体重、Apgar 5 min评分、产前激素使用和孕母维生素D补充比例低于轻症组(P<0.05)。多因素Logistic回归分析显示胎龄、产前使用激素、出生体重、Apgar 5 min评分、孕母补充维D及患儿血清25(OH)D、血清总蛋白水平是影响新生儿肺炎病情严重程度的相关因素(P<0.05)。ROC曲线分析结果显示,血清25(OH)D能预测新生儿肺炎病情程度及预后的曲线下面积分别为0.758和0.782,灵敏度和特异度分别为96.4%,52.3%和89.2%,54.7%。结论血清25(OH)D水平在重症肺炎患儿中水平较低,能反映新生儿病情严重程度,并对其病情及预后具有较高的预测价值。

Objective To investigate the relationship between serum 25(OH)D level and the severity of neonatal pneumonia and its prognostic value.Methods From June 2021 to June 2023,264 children diagnosed with neonatal pneumonia in Qilu Hospital of Shandong University were selected as the research objects.According to the severity of pneumonia,87 cases were divided into severe pneumonia group and 177 cases were divided into mild pneumonia group.The Baseline data and serum 25-(OH)D levels were compared between two groups.Multivariate Logistic regression analysis was used to analyze the influencing factors of neonatal pneumonia severity;ROC curve was used to analyze the predictive value of serum 25(OH)D level for neonatal pneumonia severity and prognosis.Results The serum 25(OH)D,calcium,and total serum protein levels in severe pneumonia group were lower than those in mild pneumonia group,alkaline phosphatase levels are higher than those in the mild group(P<0.05).The gestational age,birth weight,Apgar 5 min score,prenatal hormone use and the proportion of vitamin D supplementation in pregnant women in severe pneumonia group were lower than those in mild pneumonia group(P<0.05).Multivariate Logistic regression analysis showed that gestational age,antenatal hormone use,birth weight,Apgar 5 min score,maternal vitamin D supplementation the child'sserum 25(OH)D and total protein levels were the related factors affecting the severity of neonatal pneumonia(P<0.05).ROC curve analysis showed that the area under the curve(AUC)of serum 25(OH)D for predicting the severity and prognosis of neonatal pneumonia were 0.758 and 0.782,respectively,and the sensitivity and specificity were 96.4%,52.3%and 89.2%,54.7%,respectively.Conclusion The level of serum 25(Ox)D in children with severe pneumonias was relatively low.It could reflect the severity of the newborn's condition and had a high prediction value for the patient's condition and prognosis.