PICU患儿维生素D缺乏情况分析

目的 研究因感染入住儿童重症监护室(PICU)的患儿血清中维生素D水平与患儿疾病转归间的关系,并探讨其临床意义。 方法 选取因感染入住PICU的患儿378例,分析感染性疾病的主要类型,检测其血清25-(OH)D水平,并与同期门诊体检的350例健康儿童血清25-(OH)D水平进行比较。同时,根据25-(OH)D水平将PICU患儿分为维生素D缺乏组114例及维生素D正常组264例,比较2组患儿间一般情况、住院时间、PRISM评分及预后转归情况。 结果 导致儿童入住PICU的感染主要为感染性休克、严重呼吸系统或消化系统感染。PICU患儿血清25-(OH)D平均(63.5±19.9)nmol/L,显著低于健康儿童(76.8±17.1)nmol/L(P<0.01),且维生素D缺乏比例(30.2%)也较健康儿童组高(18.6%,P<0.05)。在PICU患儿中,维生素D缺乏组年龄(4.1±1.8)岁,较维生素D正常组(2.7±1.4)岁大(P<0.01),维生素D缺乏组住院时间(5.2±1.1)d较正常组延长(P<0.01)。但维生素D水平与患儿PRISM评分间无显著关系(P>0.05),且与患儿死亡无相关性(P>0.05)。 结论 因感染入住PICU的患儿维生素D缺乏明显,维生素D缺乏会导致感染性疾病恢复较慢,但并不影响患儿疾病严重程度或死亡率。 

The analysis of vitamin D deficiency with children in PICU

Objective To study the serum vitamin D levels in children who were send to PICU because of infection, analyze the relationship between vitamin D levels and disease outcome and explore its clinical significance. Methods Three hundred and seventy-eight cases of patients who were sent to PICU because of infection were included, and the main types of infection were ensured when they hospitalized. The 25-(OH)D level in serum was detected and compared with 350 cases of healthy children, who come to body check or vaccination in our outpatient service at the same term. Meanwhile, PICU patients were divided into two groups according to their 25-(OH)D level:normal 25-(OH)D group 264 cases and lack 25-(OH)D group 114 cases. General condition, hospital length of stay (HLOS), PRISM score and prognosis were compared between the two groups. Results The main infection that cause children hospitalized into PICU were septic shock, serious respiratory or digestive system infection. Serum 25-(OH)D in PICU children (63.5±19.9) nmol/L was lower than healthy children (76.8±17.1) nmol/L (P<0.01), and the ratio of 25-(OH)D lacking (30.2%) was also higher than healthy children(18.6%), P<0.05. In PICU patients, lack 25-(OH)D group children were elder than normal 25-(OH)D group (P<0.01). HLOS was longer in lack 25-(OH)D group (P<0.01). But 25-(OH)D level was neither related to PIRSM score (P>0.05) nor correlated to children death (P>0.05). Conclusion Children hospitalized into PICU because of infection are lacking 25-(OH)D obviously, lack of 25-(OH)D leads to slow recovery of infection diseases, but does not affect the severity of diseases or mortality in children.