摘要
目的研究危重症患儿血清25羟维生素D_3[25(OH) D_3]、维生素D结合蛋白(VDBP)的检测指标水平及临床意义。方法将2017年1月-2018年10月于本院儿科接受诊治的268例危重症患儿作为观察组,并依据血清25-(OH) D_3水平分成25-(OH) D_3缺乏组105例、不足组88例、充足组75例;另选择同期于本院儿科门诊接受健康体检的200例正常儿童作为对照组。分析观察组患儿的临床资料及治疗前、治疗第7 d后血清25-(OH) D_3、VDBP表达水平。结果观察组血清25-(OH) D_3、VDBP表达水平均低于对照组,充足组血清25-(OH) D_3水平高于不足组、缺乏组,差异有统计学意义(P <0. 05);充足组、不足组、缺乏组患儿的BMI、机械通气率、血清Ca、器官障碍/衰竭发生率、第28 d病死率对比,差异无统计学意义(P> 0. 05);危重症患儿治疗第7 d后血清25-(OH) D_3、VDBP表达水平均高于治疗前;病死组患儿的血清25-(OH) D_3、VDBP表达水平均低于存活组,PRISM Ⅲ评分高于存活组,差异有统计学意义(P <0. 05)。结论血清25-(OH) D_3、VDBP缺乏、不足的危重症患儿PICU入住时间长,PRISMⅢ评分及病死风险高;提示积极检测血清25-(OH) D_3、VDBP表达水平能帮助医师评估危重症患儿病情严重程度、治疗效果以及预后康复质量。
Objective To study the detection level and clinical significance of serum 25 hydroxyvitamin D3[25(OH)D3]and vitamin D binding protein(VDBP)in critically ill children.Methods A total of 268 critically ill children admitted to our hospital from January 2017 to October 2018 were enrolled in the observational group.According to the serum 25-(OH)D3 level,105 patients were enrolled in 25-(OH)D3 deficiency group,88 cases in insufficient group and 75 cases in sufficient group;Another 200 normal children who underwent a physical examination at the pediatric outpatient clinic of the hospital were selected as the control group.The clinical data of the children in the observation group and the levels of serum 25-(OH)D3 and VDBP before and at 7 d of treatment were analyzed.Results The levels of serum 25-(OH)D3 and VDBP in the observation group were lower than those in the control group.The serum levels of 25-(OH)D3 in the adequate group were higher than those in the insufficient group and the lack group(P<0.05).There was no statistical significance on the differences in BMI,mechanical ventilation rate,serum Ca,organ disorder/failure rate,and 28 d mortality between the adequate group,the insufficient group,and the lack group(P>0.05).The levels of serum 25-(OH)D3 and VDBP in critically ill children after treatment for 7 days were higher than those before treatment;the serum levels of 25-(OH)D3 and VDBP in the patients with disease and death were lower than those in the survival group,and the PRISMⅢscore was higher than that in the survival group,with the differences statistically significant(P<0.05).Conclusion Children with critically ill serum 25-(OH)D3,VDBP deficiency and deficiency have long PICU stay,high PRISMⅢscore and high risk of death;it is suggested that active detection of serum 25-(OH)D3 and VDBP levels can help physicians to assess the severity of the disease,the therapeutic effect and the quality of prognosis in critically ill children.
作者
黄邀
吴惠兰
阮奕
HUANG Yao;WU Hui-lan;RUAN Yi(Department of Pediatrics,Taithou Hospital,Taizhou,Zhejiang 318000,China)
出处
《中国卫生检验杂志》
CAS
2020年第9期1110-1113,共4页
Chinese Journal of Health Laboratory Technology
