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目的探讨早期口服不同剂量维生素D对早产儿钙磷代谢及白细胞介素2(IL-2)的影响。方法选择2012年1月至2014年1月入住我院新生儿监护病房的90例早产儿为研究对象,随机分为A组、B组和对照组,每组各30例;对照组给予配方奶喂养及部分肠外营养支持。A组生后第3天起给予口服维生素D 400 IU/d,连续14天;B组生后第3天起给予口服维生素D800 IU/d,连续14天。观察3组早产儿治疗前后血清Ca、P、25-(OH)D_3和IL-2水平变化。结果纳入分析87例,A组28例,B组29例,对照组30例。出生后第1天仅8例(9.2%)维生素D充足,各组早产儿维生素D充足比例差异无统计学意义(P>0.05);A组、B组治疗第7、14天维生素D充足比例高于对照组(P<0.05);A组与B组治疗第7天维生素D充足比例差异无统计学意义(P>0.05),治疗第14天B组充足比例高于A组(P<0.05)。口服维生素D前各组早产儿血清Ca、P、25-(OH)D_3、IL-2水平差异均无统计学意义(P>0.05);治疗第7天及第14天A组、B组血清Ca、P、25-(OH)D_3、IL-2水平均高于对照组,B组血清Ca、P、25-(OH)D_3、IL-2水平高于A组,差异有统计学意义(P<0.05)。结论早产儿生后第3天开始补充维生素D 800 IU/d较400 IU/d更能改善钙磷代谢状态,且可提高血清IL-2水平。
Objective To investigate the effect of early oral administration of different doses of vitamin D on calcium and phosphorus metabolism and interleukin 2 (IL-2) in preterm infants. Methods Ninety preterm infants admitted to our neonatal care unit from January 2012 to January 2014 were randomly divided into A group, B group and control group, with 30 cases in each group. The control group was given formula milk Feeding and partial parenteral nutrition support. Group A was given oral vitamin D 400 IU / d on the third day after giving birth for 14 consecutive days; Group B received oral vitamin D 800 IU / d on the third day after birth for 14 consecutive days. The changes of serum Ca, P, 25- (OH) D 3 and IL-2 levels in preterm infants were observed before and after treatment. The results were included in the analysis of 87 cases, A group of 28 cases, B group 29 cases, control group 30 cases. On the first day after birth, only 8 cases (9.2%) had adequate vitamin D, and there was no significant difference in the adequacy of vitamin D between preterm infants in each group (P> 0.05). In group A and B, the adequate ratio of vitamin D (P <0.05). There was no significant difference in the adequate ratio of vitamin D on the 7th day between the A and B groups (P> 0.05). On the 14th day, the adequate ratio of B group was higher than that of the A group (P <0.05) ). The levels of serum Ca, P, 25- (OH) D_3 and IL-2 in preterm infants before oral administration of vitamin D were not significantly different (P> 0.05). On the 7th and 14th days, The levels of Ca, P, 25- (OH) D_3 and IL-2 were higher in the control group than in the control group. The levels of Ca, P, 25- (OH) D_3 and IL-2 in group B were significantly higher than those in group A P <0.05). Conclusions Supplementation of vitamin D 800 IU / d on the third day after birth in preterm infants can improve the metabolism status of calcium and phosphorus more than 400 IU / d and increase the level of serum IL-2.