早产儿25羟维生素D含量测定及相关因素分析
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Measurement of 25-hydroxyvitamin D in preterm infants and its related factors
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    目的:测定早产儿25羟维生素D含量,探讨影响早产儿25羟维生素D含量的主要因素。方法:选取2012年5月—2013年9月在无锡市妇幼保健院和无锡市第三人民医院出生-住院的新生儿,早产儿组50例,足月儿组50例,记录出生时的基本情况,根据不同目的将研究对象分为不同组别。采用酶联免疫法测定早产儿和足月儿25羟维生素D含量,用常规生化法测定钙-磷-碱性磷酸酶(alkaline phosphatase,ALP)值,定量超声技术测定骨密度(bone mineral density,BMD)值。结果:①出生时早产儿组25羟维生素D含量低于足月儿组,差异有统计学意义(P < 0.01)。②按胎龄分组,A组(28周≤胎龄≤32周)新生儿血25羟维生素D含量均低于B组(32周<胎龄<37周)-C组(37周≤胎龄<39周)-D组(39周≤胎龄≤42周)(P均<0.01);按出生时体重分组,各体重组血25羟维生素D水平两两比较均有显著性差异(P均<0.01)。③早产儿组按孕母是否规律性补充维生素D或钙剂分成规律补充-不规律补充和未补充3组,3组之间血25羟维生素D水平两两比较均有显著性差异(P < 0.05)。④早产儿出生时25羟维生素D含量与胎龄-出生体重呈正相关(P < 0.05);足月儿出生时25羟维生素D含量与胎龄-性别-出生体重及出生方式均无显著相关(P >0.05)。⑤早产儿和足月儿出生时血钙-磷-ALP值均无显著性差异(P > 0.05);早产儿组25羟维生素D与ALP呈显著性负相关(P < 0.01);足月儿组25羟维生素D与ALP-钙-磷值均无显著性相关(P > 0.05)。⑥早产儿和足月儿BMD有显著差异(P < 0.01);早产儿组BMD与胎龄-出生体重-25羟维生素D呈正相关(P < 0.05),与ALP呈负相关(P < 0.05);足月儿组BMD与胎龄-25羟维生素D呈正相关(P < 0.05)。结论:①早产儿出生时25羟维生素D含量明显低于足月儿;②早产儿出生时的胎龄-体重以及孕母在整个孕期中是否规律性补充维生素D制剂或钙剂是影响早产儿出生时25羟维生素D含量的主要因素。

    Abstract:

    Objective:To measure the content of 25-hydroxyvitamin D in preterm infants, and to investigate factors contributing to it. Methods: A total of 100 infants that were born in Maternal and Child Health Hospital and the 3rd People's Hospital of Wuxi from 05/2012 to 09/2013 were selected as subjects, 50 of which were preterm infants and the other 50 were full-term. Basic situations of birth were recorded and subjects were divided into groups according to different purposes. 25-hydroxyvitamin D in preterm and full-term infants and their corresponding mothers were measured by enzyme-linked immunosorbent assay;calcium, phosphorus, alkaline phosphatase (ALP) were measured using conventional biochemical method;bone mineral density (BMD) values were measured by quantitative ultrasound (QUS). Results: ① 25-hydroxyvitamin D in preterm infants was significantly lower than that detected in full-term infants (P < 0.01). ② 25-hydroxyvitamin D of the preterm group A (28 w≤gestational age≤32 w) was significantly lower than those of the group B (32 w≤gestational age≤37 w), group C (37 w≤gestational age≤39 w) and group (39 w≤gestational age≤42 w) (both P < 0.01). Infants were also divided into 3 groups according to neonatal body weight. All pairwise comparision showed significant difference (both P < 0.01). ③Preterm infants were divided into 3 groups: the regular implement, sporadic implement, and no implement of 25-hydroxyvitamin D groups. All pairwise comparision of the three groups showed significant difference (P < 0.05);④25-hydroxyvitamin D level of preterm infants was positively correlated with gestational age and neonatal body weight (P < 0.05). However, in full-term infants, none of these factors showed significant correlation (P > 0.05). ⑤There was no significant difference in serum calcium, phosphorus, and ALP between preterm and full-term infants (P > 0.05). In the preterm group, 25-hydroxyvitamin D was negatively correlated with ALP (P < 0.01). ⑥BMD difference between preterm infants and full-term ones was significant (P < 0.01). BMD of preterm infants was positively linked to gestational age, neonatal body weight and 25-hydroxyvitamin D level (P < 0.05), and was negatively linked to alkaline phosphatase(P < 0.05). In full-term infants, BMD was significantly correlated with gestational age and 25-hydroxyvitamin D level(P < 0.05). Conclusion: ① 25-hydroxyvitamin D is significantly lower in preterm infants than that in full-term ones; ②Gestational age, birth weight, and vitamin D or calcium supplementation of the mother have great influence on 25-hydroxyvitamin D level of neonatal preterm infants.

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赵光耀,查 洪.早产儿25羟维生素D含量测定及相关因素分析[J].南京医科大学学报(自然科学版),2015,(11):1643-1648

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  • 收稿日期:2015-07-13
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  • 在线发布日期: 2015-11-30
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