脓毒症患儿血清25-羟维生素D水平变化及意义

发布时间：2018-05-12 02:17

  本文选题：25-羟维生素D + 疾病严重程度　； 参考：《新疆医科大学》2017年硕士论文

【摘要】：目的:讨论PICU患儿血清25-羟维生素D水平是否较正常体检儿血清25-羟维生素D水平低。探讨血清25-羟维生素D水平对脓毒症患儿的病情严重程度和预后的影响。方法:通过临床回顾性研究分析2014年12月-2016年12月期间在新疆医科大学第一附属医院PICU确诊并治疗的125例脓毒症患儿进行回顾性研究。检测血清25(OH)D水平、血白细胞(WBC)、降钙素原(PCT)、白介素6(IL-6)、超敏C反应蛋白(CRPH),活化部分凝血活酶时间(APTT)、凝血酶原时间(PT)、谷草转氨酶(AST)、谷丙转氨酶(ALT)、血沉(ESR),并记录小儿危重症评分(PCIS评分)。首先,将在我院收集的125例脓毒症患儿同同时期就诊我院门诊体检的50例正常体检儿血清25-羟维生素D水平进行比较,得出结论为PICU患儿的25-羟维生素D水平低于健康对照。然后根据血清25(OH)D水平将患儿分为充足组(≥75mmol/L)、不足组(50~75mmol/L)、缺乏组(50mmol/L),进行组间比较;其次以患者28天转归情况为终点,再对生存组与死亡组进行比较。用Logistic回归分析确定影响预后的独立因素。结果:维生素D缺乏组、不足组、充足组患儿分别为75例(60%)、40例(32.0%)、10例(8%)。三组间两两比较显示,缺乏组的病死率(37.3%)比不足组(7.5%)和充足组(0%)明显升高(P0.05),缺乏组的严重脓毒症和脓毒症休克患者比例及PCIS评分显著高于充足组(P0.05)。生存组(94例)与死亡组(31例)间比较,25(OH)D水平、PCIS评分、PCT和CRPH的差异有统计学意义(P0.05),25(OH)D水平和PCIS评分是脓毒症患者28天病死率的独立影响因素。结论:PICU患儿的25-羟维生素D水平低于健康对照。血清25(OH)D水平的降低可能加重脓毒症患者的病情、增加死亡风险,影响患者预后。
[Abstract]:Objective: to investigate whether the serum 25-hydroxyvitamin D level in children with PICU is lower than that in normal children. To investigate the effect of serum 25-hydroxyvitamin D level on the severity and prognosis of sepsis children. Methods: from December 2014 to December 2016, 125 children with sepsis diagnosed and treated by PICU in the first affiliated Hospital of Xinjiang Medical University were retrospectively analyzed. The levels of serum 25(OH)D, serum WBCU, procalcitonin, interleukin-6 (IL-6), hyper-sensitive C-reactive protein (25(OH)D), activated partial thromboplastin time (APTTT), prothrombin time (PTT), aspartate aminotransferase (alt), alanine aminotransferase (alt), erythrocyte sedimentation rate (ESR) were measured. Firstly, the serum levels of 25-hydroxyvitamin D in 125 septic children collected in our hospital were compared with those in 50 normal children at the same time. It was concluded that the level of 25-hydroxyvitamin D in children with PICU was lower than that in healthy controls. Then the children were divided into sufficient group (鈮，

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