摘要
目的观察孕末期不同剂量维生素D对新生儿血清25-羟基维生素D[25-(OH)D]及免疫水平的影响。方法选取2018年1月-2019年12月南宁市第八人民医院产科产检和足月分娩的足量补充维生素D(600 U/d)产妇及新生儿200例作为对照组,另选取同期孕末期大剂量补充维生素D(4000 U/d)的182例产妇及新生儿作为观察A组,不足量补充(<600 U/d)、不补充维生素D或间断补充维生素D(停止补充时间>7 d、3个月内累记>30 d或连续>15 d)的产妇及新生儿167例作为观察B组。比较3组产妇与新生儿的25-(OH)D水平、25-(OH)D缺乏率,比较3组新生儿血清免疫球蛋IgG、IgA、IgM和补体C_(3)、C_(4)水平,新生儿感染发生情况。分析母婴25-(OH)D水平相关性、产妇25-(OH)D水平与新生儿感染相关性。结果观察A组新生儿及母体血清25-(OH)D水平高于对照组及观察B组,观察A组新生儿血清免疫球蛋白IgA、IgM及补体C_(3)、C_(4)水平高于对照组,而对照组感染发生率高于观察A组(P均<0.05);在足量补充维生素D情况下,新生儿血清25-(OH)D水平与免疫球蛋白IgA、IgM及补体C_(3)、C_(4)呈正相关,在维生素D补充不足情况下,新生儿血清25-(OH)D水平与免疫球蛋白IgA、IgG及补体C_(3)、C_(4)呈正相关,与IgM呈负相关。结论新生儿25-(OH)D缺乏可导致机体免疫力低下,可能是新生儿感染的重要因素,孕末期大剂量补充维生素D可预防新生儿25-(OH)D缺乏。
Objective To observe the effects of different doses of vitamin D at the end of pregnancy on serum 25 hydroxyvitamin d[25-(OH)D]and immune level of newborns.Methods 200 pregnant women and newborns with sufficient vitamin D supplementation(600 U/D)during obstetric examination and full-term delivery in Nanning Eighth People′s Hospital from January 2018 to December 2019 were selected as the control group.In addition,182 pregnant women and newborns who received high-dose vitamin D(4000 U/D)at the end of pregnancy were selected as observation group A.167 parturients and newborns with insufficient supplement(<600 U/D),no supplement of vitamin D or intermittent supplement of vitamin D(stop supplement time>7 days,accumulated within 3 months>30 days or continuous>15 days)were observed as group B.The 25-(OH)D level and 25-(OH)D deficiency rate of the three groups of parturients and newborns were compared.The levels of serum immunoglobulin IgG,IgA,IgM,complement C_(3) and C_(4) and the incidence of neonatal infection were compared.The correlation between maternal and infant 25-(OH)D level,maternal 25-(OH)D level and neonatal infection were analyzed.Results The levels of serum 25-(OH)D in newborns and mothers in group A were higher than those in control group and observation group B.the levels of serum immunoglobulin IgA,IgM and complement C_(3) and C_(4) in newborns in group A were higher than those in control group,and the incidence of infection in control group was higher than that in observation group A(all P<0.05).Under the condition of sufficient vitamin D supplementation,the level of serum 25-(OH)D was positively correlated with immunoglobulin IgA,IgM and complement C_(3) and C_(4).In the case of insufficient vitamin D supplement,the level of serum 25-(OH)D was positively correlated with immunoglobulin IgA,IgG,complement C_(3) and C_(4),and negatively correlated with IgM.Conclusion 25-(OH)D deficiency can lead to low immunity of newborns,which may be an important factor of neonatal infection,and high-dose vitamin D s
作者
陆俐先
王兆康
许成芳
黄淑清
林丽霞
罗淑芬
LU Lixian;WANG Zhaokang;XU Chengfang;HUANG Shuqing;LIN Lixia;LUO Shufen(Department of Neonatology,Nanning Eighth People′s Hospital,Guangxi Zhuang Autonomous Region,Nanning 530001,China)
出处
《临床合理用药杂志》
2022年第2期28-31,35,共5页
Chinese Journal of Clinical Rational Drug Use
