摘要
目的分析新生儿维生素D水平的现状,为促进孕期及新生儿保健提供理论依据。方法在该院新生儿重症监护室住院的295例,其中早产儿组189例,足月儿组106例,分析比较两组一般情况,包括胎龄、出生体重、身长、头围;血清指标包括血清25羟维生素D(25OHD)、碱性磷酸酶(ALP)、钙、磷以及母孕期添加维生素D情况。并比较不同出生体重及胎龄早产儿血清25OHD的差异。结果早产儿组与足月儿组间血清磷及ALP差异无统计学意义(t值分别为-0.535、-0.591,均P>0.05),早产儿组血清钙低于足月儿组,差异有统计学意义(t=-3.602,P<0.05)。早产儿组25OHD(17.05±8.14)μg/L,处于明显低水平,虽低于足月儿组水平[(18.31±8.99)μg/L],但差异无统计学意义(t=-1.223,P>0.05)。295例新生儿血清25OHD最低为3.00μg/L,最高为71.78μg/L,维生素D缺乏占70.17%,血清25OHD<5μg/L:4.07%(12/295);<30μg/L:93.90%(277/295)。其中早产儿维生素D缺乏占72.49%(137/189),足月儿维生素D缺乏占66.04%(70/106),两者差异无统计学意义(χ2=1.349,P=0.289);<30μg/L者,早产儿占95.24%(180/189),足月儿占91.51%(97/106);两者差异无统计学意义(χ2=1.648,P=0.213)。但是早产儿有12例(6.35%)维生素D严重缺乏,足月儿无。母孕期累积补充了3个月以上的早产儿组仅占16.40%,足月儿组占13.21%,两者差异无统计学意义(χ2=0.620,P=0.50),孕期补维生素D不足与患维生素D缺乏直接相关,是其的危险因素[早产儿不同出生体重血清25OHD不同,差异有统计学意义(F=2.762,P=0.029)。不同胎龄早产儿血清25OHD不同,差异有统计学意义(F=3.144,P=0.045)。结论现阶段足月儿与早产儿一样存在普遍且严重的维生素D不足,孕期维生素D补充不足与新生儿维生素D缺乏密切相关,需加强母孕期及新生儿维生素D的补充。
Objective To analyze the status of vitamin D levels in neonates,provide a theoretical basis for promoting gestational and neonatal health care. Methods A total of 295 neonates from NICU were selected and divided into premature infant group（ 189 infants） and mature infant group（ 106 infants）. The general situations（ fetal age,birth weight,height,head circumference） and serum indexes [25hydroxyvitamin D（ 25OHD）,alkaline phosphatase（ ALP）,calcium,phosphate and vitamin D intake of their mothers in pregnancy]in the two groups were compared. The differences of serum 25 OHD levels among the premature infants with different birth weights and fetal age were compared. Results There was no statistically significant difference in serum phosphate and ALP levels between the two groups（ t =-0. 535,-0. 591,P〉0. 05）; the level of serum calcium in premature infant group was statistically significantly lower than that in mature infant group（ t=-3. 602,P〈0. 05）; the level of 25 OHD in premature infant group was（ 17. 05±8. 14） μg/L,which was lower than that in mature infant group [（ 18. 31±8. 99） μg / L],but there was no statistically significant difference（ t =-1. 223,P〉0. 05）; the level of serum 25 OHD ranged from 〈3. 00 μg / L to 71. 78 μg / L,the incidence rate of vitamin D deficiency was 70. 17%,the proportion of neonates with serum 25 OHD level 〈5 μg / L accounted for 4. 07%（ 12 /295）,and the proportion of neonates with serum 25 OHD level 30 μg / L accounted for93. 90%（ 277 /295）. The incidence rates of vitamin D deficiency in premature infant group and mature infant group were 72. 49%（ 137 /189） and 66. 04%（ 70 /106）,respectively,there was no statistically significant difference between the two groups（ χ^2= 1. 349,P =0. 289）; the proportions of neonates with serum 25 OHD level 〈30 μg / L in premature infant group and mature infant group were 95. 24%（ 180 /189） and 91. 51%（ 97 /106）,respectively,there was no statistically significant diffe
出处
《中国妇幼保健》
CAS
2017年第2期291-295,共5页
Maternal and Child Health Care of China
