摘要
目的 分析极早产儿血清25-羟维生素D[25-(OH)D]水平不足的影响因素,并分析血清25-(OH)D水平与坏死性小肠结肠炎(NEC)的关系。方法 选取2018年5月至2023年5月收治的极早产儿200例。检测患儿出生后2 h内血清25-(OH)D水平,统计血清25-(OH)D水平不足发生率,将血清25-(OH)D水平不足极早产儿纳入不足组,血清25-(OH)D水平正常极早产儿纳入正常组,比较2组临床资料,分析血清25-(OH)D水平不足的影响因素。比较2组出生后28 d内NEC发生率,并比较发生与未发生NEC极早产儿血清25-(OH)D水平。分析血清25-(OH)D水平预测NEC发生的价值。结果 血清25-(OH)D水平不足率为68.50%(137/200)。血清25-(OH)D水平不足组极早产儿母亲妊娠期糖尿病(GDM)发生率、妊娠期高血压(GH)发生率高于正常组,产前血清25-(OH)D水平低于正常组(P<0.01);血清25-(OH)D水平不足组极早产儿冬春季出生率[59.12%(81/137)]高于正常组[31.75%(20/63)],差异有统计学意义(P<0.01);母亲GDM、GH、产前血清25-(OH)D水平及极早产儿出生季节均为血清25-(OH)D水平不足的影响因素(P<0.01);血清25-(OH)D水平不足组NEC发生率[17.52%(24/137)]高于正常组[4.76%(3/63)],差异有统计学意义(P<0.05);发生NEC极早产儿血清25-(OH)D水平低于未发生NEC极早产儿(P<0.01);血清25-(OH)D水平预测极早产儿发生NEC的曲线下面积为0.850(95%CI:0.792,0.896),敏感度、特异度分别为92.59%、71.10%。结论 极早产儿血清25-(OH)D水平不足的影响因素包括母亲GDM、GH、产前血清25-(OH)D水平及极早产儿出生季节,且血清25-(OH)D水平不足与NEC的发生密切相关。
Objective To analyze the influencing factors of insufficient serum 25-hydroxyvitamin D [25-(OH) D] levels in extremely premature infants,and to investigate the relationship between serum 25-(OH) D levels and necrotizing enterocolitis(NEC).Methods A total of 200 extremely premature infants admitted from May 2018 to May 2023 were selected.Serum 25-(OH) D levels were measured within 2 h after birth in the infants,and the incidence of insufficient serum 25-(OH) D levels was calculated.Infants with insufficient serum 25-(OH) D levels were included in the insufficient group,while infants with normal serum 25-(OH) D levels were included in the normal group.Clinical data of the two groups were compared,and factors influencing insufficient serum 25-(OH) D levels were analyzed.The incidence of NEC within 28 d after birth was compared between the two groups,and the serum 25-(OH) D levels were compared between infants with and without NEC.The value of serum 25-(OH) D levels in predicting NEC was analyzed.Results The insufficient rate of serum 25-(OH) D levels was 68.50%(137/200).The incidence of maternal gestational diabetes mellitus(GDM) and gestational hypertension(GH) of extremely preterm infants in insufficient serum 25-(OH) D level group was higher than that in the normal group,and the prenatal serum 25-(OH) D levels were lower than those in the normal group(P<0.01).The birth rate of extremely preterm infants in the insufficient serum 25-(OH) D level group during winter and spring [59.12%(81/137)] was higher than that in the normal group [31.75%(20/63)],with a significant difference(P<0.01).Maternal GDM,GH,prenatal serum 25-(OH) D levels,and the birth season of extremely preterm infants were all influencing factors of insufficient serum 25-(OH) D levels(P<0.01).The incidence of NEC in the insufficient serum 25-(OH) D level group [17.52%(24/137)] was higher than that in the normal group [4.76%(3/63)],with a significant difference(P<0.05).The serum 25-(OH) D levels of extremely preterm infants with NEC were lower than those without NEC(P<0.01).The area under the receiver operating characteristic curve for predicting the occurrence of NEC in extremely preterm infants based on serum 25-(OH) D levels was 0.850(95%CI:0.792,0.896),with a sensitivity of 92.59% and a specificity of 71.10%.Conclusion The influencing factors of insufficient serum 25-(OH) D levels in extremely premature infants include maternal GDM,GH,prenatal serum 25-(OH) D levels,and the birth season of the extremely premature infants.Furthermore,insufficient serum 25-(OH) D levels are closely related to the occurrence of NEC.
作者
张敏
杨立
王文秀
姚秋雨
ZHANG Min;YANG Li;WANG Wenxiu;YAO Qiuyu(Department of Neonatology,Tongzhou District Maternal and Child Health Hospital of Beijing,Beijing 101100,China;Department of General Pediatrics,Tongzhou District Maternal and Child Health Hospital of Beijing,Beijing 101100,China)
出处
《临床误诊误治》
2025年第9期82-86,103,共6页
Clinical Misdiagnosis & Mistherapy
基金
北京市卫生健康委员会北京市卫生健康科技成果和适宜技术推广项目(BHTPP202019)
北京市通州区科技计划项目(KJ2022CX055)。
关键词
极早产儿
25-羟维生素D
坏死性小肠结肠炎
妊娠期糖尿病
妊娠期高血压
受试者工作特征
曲线下面积
预测
Extremely premature infants
25⁃hydroxyvitamin D
Necrotizing enterocolitis
Gestational diabetes
Gestational hypertension
Receiver operating characteristic
Area under the curve
Prediction
