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出生时维生素 D 状况与极早产儿肺部疾病发病率的关系。

Association of vitamin D status at birth with pulmonary disease morbidity in very preterm infants.

机构信息

Division of Neonatology, Department of Pediatrics, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China.

Laboratory of Neonatal Disease, Institute of Pediatrics, Central South University, Changsha, Hunan, China.

出版信息

Pediatr Pulmonol. 2021 May;56(5):1215-1220. doi: 10.1002/ppul.25233. Epub 2020 Dec 23.

Abstract

OBJECTIVE

We aimed to assess whether serum 25-hydroxyvitamin D (25(OH)D) levels at birth are associated with pulmonary disease morbidities in very preterm infants.

METHODS

This prospective cohort analysis included 93 infants born before 32 weeks of gestation in the Second Xiangya Hospital of Central South University between March 2016 and February 2017. Participants were classified into three groups according to their 25(OH)D levels at birth. The groups were compared in terms of demographic variables and pulmonary disease morbidities.

RESULTS

The mean serum 25(OH)D level at birth was 35.7 ± 19.1 nmol/L, and 38 (40.9%), 31 (33.3%), and 24 (25.8%) infants had 25(OH)D levels of less than 25 nmol/L, 25-50 nmol/L, and more than or equal to 50 nmol/L, respectively. There was a statistically significant difference in neonatal respiratory distress syndrome (RDS) rates among the three groups (43.6% vs. 35.9% vs. 20.5%, p = .029). The rates of bronchopulmonary dysplasia, apnea, respiratory failure, persistent pulmonary hypertension, and pulmonary hemorrhage did not differ significantly among the groups. Logistic analysis, adjusted for gestational age and birth weight, showed that a low serum 25(OH)D level (<50 nmol/L) was a risk factor for RDS (odds ratio, 0.195; p = .017).

CONCLUSION

There was a high prevalence of low 25(OH)D levels (<50 nmol/L) and an association between vitamin D status and RDS in very preterm infants. However, more research on this association is required.

摘要

目的

评估新生儿血清 25-羟维生素 D(25(OH)D)水平与极早产儿肺部疾病发病情况之间的关系。

方法

本前瞻性队列研究纳入了 2016 年 3 月至 2017 年 2 月在中南大学湘雅二医院出生的 93 例胎龄<32 周的早产儿。根据新生儿出生时的 25(OH)D 水平将患儿分为 3 组,比较各组患儿的一般资料和肺部疾病发病情况。

结果

新生儿出生时血清 25(OH)D 平均水平为 35.7±19.1 nmol/L,其中 25(OH)D<25 nmol/L、25~50 nmol/L 和≥50 nmol/L 者分别占 40.9%(38 例)、33.3%(31 例)和 25.8%(24 例)。三组患儿中新生儿呼吸窘迫综合征(RDS)发生率差异有统计学意义(43.6%比 35.9%比 20.5%,p=0.029)。各组患儿支气管肺发育不良、呼吸暂停、呼吸衰竭、持续性肺动脉高压和肺出血发生率差异均无统计学意义。经胎龄和出生体重校正的 logistic 分析显示,低血清 25(OH)D 水平(<50 nmol/L)是 RDS 的危险因素(比值比,0.195;p=0.017)。

结论

极早产儿普遍存在低 25(OH)D 水平(<50 nmol/L),且维生素 D 状态与 RDS 发病相关。但仍需进一步研究二者之间的关联。

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