早产儿维生素D两种补充方案的疗效对比：前瞻性随机对照研究

A comparative analysis of the efficacy of two vitamin D supplementation regimens in preterm infants: a prospective randomized controlled study

摘要:

目的 探讨不同维生素D补充方案对出生胎龄 < 34周早产儿生后第28天维生素D营养状况的影响。方法 将59例2018年10月至2019年10月出生胎龄 < 34周的住院早产儿随机分为肌注组（n=30）和口服组（n=29）。肌注组单次肌内注射维生素D₃注射液（10 000 IU/kg），口服组口服维生素D₃滴剂（900 IU/d），持续25 d。采集两组患儿生后48 h内（维生素D₃补充前）及第28天静脉血，检测血清25-羟维生素D[25(OH) D]水平。结果 生后48 h内，59例早产儿维生素D缺乏（≤15 ng/mL）率为78%；两组血清25(OH) D水平及维生素D缺乏率比较差异无统计学意义（P > 0.05）。生后第28天，肌注组血清25(OH) D水平显著高于口服组（P < 0.05），肌注组维生素D缺乏率显著低于口服组（P < 0.05），且无维生素D过量或中毒病例。结论 单次肌内注射10 000 IU/kg维生素D₃可显著提升出生胎龄 < 34周早产儿生后第28天血清25(OH) D水平，且能安全并有效地降低维生素D缺乏率。

Abstract:

Objective To study the effect of different vitamin D supplementation regimens on the nutritional status of vitamin D on day 28 after birth in preterm infants with a gestational age of < 34 weeks. Methods A total of 59 preterm infants with a gestational age of < 34 weeks who were born from October 2018 to October 2019 were enrolled and divided into an observation group with 30 infants and a control group with 29 infants. The infants in the observation group received a single-dose intramuscular injection of vitamin D₃ (10 000 IU/kg), while those in the control group received oral vitamin D₃ drops (900 IU/d) for 25 days. Venous blood samples were collected within 48 hours after birth (before vitamin D₃ supplementation) and on day 28 after birth to measure the serum 25-hydroxyvitamin D[25(OH)D] level. Results Within 48 hours after birth, the prevalence rate of vitamin D deficiency (≤ 15 ng/mL) was 78% among the 59 preterm infants. There were no significant differences in the serum 25(OH)D level and the prevalence rate of vitamin D deficiency between the two groups (P > 0.05). Compared with the control group on day 28 after birth, the observation group had a significantly higher serum 25(OH)D level (P < 0.05) and a significantly lower prevalence rate of vitamin D deficiency (P < 0.05). There were no cases of vitamin D overdose or poisoning. Conclusions In preterm infants with a gestational age of < 34 weeks, single-dose intramuscular injection of 10 000 IU/kg vitamin D₃ can significantly increase serum 25(OH)D level on day 28 after birth and safely and effectively reduce the prevalence rate of vitamin D deficiency.