目的 分析出生时维生素D水平与早产儿缺氧缺血性脑病(HIE)的相关性,为预防早产儿HIE提供依据。 方法 选择博罗县妇幼保健计划生育服务中心2018年6月—2020年6月诊断为HIE的早产儿25例(HIE组)和未发生HIE的早产儿138例(非HIE组),比较两组母亲和早产儿出生时血清25-(OH)D的水平,并对HIE的危险因素进行Logistic回归分析。 结果 与非HIE组比较,HIE组早产儿宫内窘迫发生率较高、1 min Apgar评分较低、机械通气时间较长,差异均有统计学意义(χ2=46.875,t=10.854、7.166,P＜0.01);HIE组母亲和早产儿出生时血清25-(OH)D水平明显低于非HIE组,差异有统计学意义(t=2.346、2.092,P＜0.05),HIE组早产儿出生时维生素D缺乏或不足的比例(64%)明显高于非HIE组(39.9%),差异有统计学意义(χ2=5.019,P＜0.05);两组母亲血清25-(OH)D水平与早产儿出生时25-(OH)D水平呈正相关(HIE组r=0.825,非HIE组r=0.682,P＜0.05)。Logistic 回归分析结果显示HIE的危险因素包括宫内窘迫(OR=1.137,95%CI:1.105～1.209)、1 min低Apgar评分(OR=1.170,95%CI:1.085～1.443)、机械通气时间(OR=1.431,95%CI:1.275～1.610)和低25-(OH)D水平(母亲OR=1.234,95%CI:1.010～1.511;早产儿OR=1.505,95%CI:1.191～1.899)。 结论 早产儿出生时维生素D缺乏或不足的比例达50.9%(83/163),母亲及早产儿出生时低维生素D水平是早产儿HIE发生的高危因素,应注重孕期和早产儿出生后的维生素D补充。
Abstract
Objective To investigate the correlation between vitamin D level at birth and hypoxic ischemic encephalopathy (HIE) in premature infants, so as to provide reference for its prevention. Methods From June 2018 to June 2020, 25 premature infants diagnosed with HIE (HIE group) and 138 children without HIE (non-HIE group) were selected as study objects from Pediatrics of Boluo County Maternal and Child Health Care Family Planning Service Center. 25-(OH)D level of umbilical artery blood at birth and maternal 25-(OH)D level were compared between the two groups. The risk factors for HIE were analyzed by Logistic regression. Results Compared with the non-HIE group, HIE group had a higher incidence of intrauterine distress(χ2=46.875), a lower Apgar score at 1min(t=10.854) and a longer mechanical ventilation time(t=7.166), and the differences were statistically significant(P＜0.01). The level of 25-(OH)D of cord blood at birth and maternal 25-(OH)D level in the HIE group were significantly lower than those in the non-HIE group(t=2.346, 2.092, P＜0.05). And the proportion of vitamin D deficiency or insufficiency at birth was significantly higher than that in the non-HIE group (64% vs. 39.9%, χ2=5.019,P＜0.05). Maternal 25-(OH)D level in the two groups was positively correlated with the 25-(OH)D level of premature infants at birth (HIE group r=0.825, non-HIE group r=0.682, P＜0.05). Logistic regression analysis showed that the risk factors for HIE included intrauterine distress (OR=1.137, 95%CI:1.105-1.209), 1min Apgar score＜5(OR=1.170, 95%CI:1.085-1.443), long mechanical ventilation time(OR=1.431, 95%CI: 1.275-1.610) and low 25-(OH)D level(Mother OR=1.234,95%CI:1.010-1.511;Preterm OR=1.505,95%CI:1.191-1.899). Conclusions The proportion of premature infants with deficiency or insufficient vitamin D at birth is 50.9% (83/163). Low vitamin D level at birth and low maternal vitamin D level are high risk factors for premature infants with HIE, and vitamin D supplementation during pregnancy and after birth should be paid attention to.
关键词
维生素D /
缺乏 /
缺氧缺血性脑病 /
早产儿
Key words
vitamin D deficiency /
hypoxic ischemic encephalopathy /
premature infants
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参考文献
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