不同血清25羟维生素D水平对早产儿脑发育的影响

Effects of different serum 25-hydroxyvitamin D levels on the brain development of preterm infants

目的:探讨不同血清25羟维生素D[25(OH)D]水平对早产儿脑发育的影响。方法:选取2021年1月~2023年1月安徽省妇幼保健院收治的早产儿293例作为研究对象,收集早产儿相关资料并测量出生48 h血清25(OH)D水平,将血清25(OH)D水平≥75 nmol/L作为正常组,<75 nmol/L作为缺乏组,均接受振幅整合脑电图(aEEG)监测并计算实际总分,参照《新生儿振幅整合脑电图临床应用专家共识》由相应胎龄早产儿的总分平均值减去实际总分得到校正后总分以评价早产儿脑发育情况。采用Pearson相关系数分析25(OH)D和早产儿脑发育的相关性。结果:293例患儿25(OH)D水平为(69.95±14.16)nmol/L,其中98例血清25(OH)D水平≥75 nmol/L,195例血清25(OH)D水平<75 nmol/L。正常组的出生胎龄[(33.76±1.92)周]较缺乏组[(32.86±2.35)周]大,正常组出生后的体质量[(2 115.80±521.37)g]较缺乏组[(1 965.56±562.41)g]重(P<0.05);正常组aEEG参数、睡眠-觉醒周期(SWC)、带宽(B)及总分均高于缺乏组(P<0.05);校正后aEEG总分(0.49±1.09)分,Pearson相关性分析显示,早产儿血清25(OH)D水平与校正后aEEG总分呈显著负相关(r=-0.343,P<0.05)。结论:血清25(OH)D和早产儿脑发育有关,监测25(OH)D水平有助于评价早产儿早期脑发育情况。

Objective:To observe the effects of different serum 25-hydroxyvitamin D[25(OH)D]levels on the brain development in preterm infants.Methods:A total of 293 preterm infants admitted to and treated in our hospital were included from January 2021 to January 2023.Relevant data of the preterm infants were collected,and serum 25(OH)D levels at 48h after birth were measured.Then the infants with serum 25(OH)D level≥75 nmol/L or<75 nmol/L were included,respectively,in normal group and in deficiency group.Meanwhile,all preterm infants underwent continuous monitoring of brain activity by amplitude-integrated electroencephalography(aEEG),based on which the actual total scoring was calculated.Finally,the corrected total scores were obtained to evaluate the brain development of the preterm infants according to the Expert Consensus on Clinical Application of Neonatal Amplitude-integrated Electroencephalography(AEEG)by subtracting the average total score of preterm infants of corresponding gestational age from the actual total scores,and Pearson correlation coefficient was used to analyze the correlation of 25(OH)D with the brain development in the preterm infants.Results:The average level of 25(OH)D was(69.95±14.16)nmol/L for the 293 children,in whom 98 had serum 25(OH)D level≥75 nmol/L,and 195 had serum 25(OH)D level<75 nmol/L.The gestational age was older,and the body weight after birth was heavier in normal group than in deficiency group[(33.76±1.92)weeks vs.(32.86±2.35)weeks;(2115.80±521.37)g vs.(1965.56±562.41)g,respectively,P<0.05]The amplitude integrated EEG parameters,sleep-wake cycle(SWC),bandwidth(B)and total score in normal group were higher than those in deficiency group(P<0.05).After correction,the total score of aEEG was(0.49±1.09)points.Pearson correlation analysis showed that the serum 25(OH)D level was significantly negatively correlated with the total score of aEEG in the preterm infants after correction(r=-0.343,P<0.05).Conclusion:Serum 25(OH)D is related to the brain development of preterm infants,and monitoring the level of 25(OH)D is helpful to estimate the early brain development of preterm infants.