目的 探討早期補充維生素D對早發(fā)型敗血癥（EOS）新生兒的血清25羥維生素D[25（OH）D]水平、炎癥因子及免疫功能的影響。方法 選取2016年1月-2019年1月宜賓市第一人民醫(yī)院兒童重癥監(jiān)護病區(qū)收治的EOS的足月新生兒120例為研究對象，所有患兒按照隨機數(shù)字表法分為對照組和觀察組，每組各60例。對照組患兒予以積極抗感染，改善通氣，適當(dāng)?shù)难鲃恿W(xué)支持，保護臟器，營養(yǎng)支持，對癥治療等；觀察組患兒在對照組的基礎(chǔ)上于出生后第3天開始口服維生素D滴劑，400 IU/d，連續(xù)服用14 d。觀察兩組患者的臨床療效，同時比較兩組治療前后的25（OH）D、白細胞介素-6（IL-6）、腫瘤壞死因子-α（TNF-α）、抗菌肽-37（LL-37）水平，以及免疫球蛋白（Ig）M、IgG和T淋巴細胞亞群指標水平。結(jié)果 觀察組的有效率為86.67%，明顯高于對照組的66.67%，兩組有效率比較差異有統(tǒng)計學(xué)意義（P<0.05）。治療后，觀察組25（OH）D水平顯著高于本組治療前（P<0.05），且治療后，觀察組25（OH）D水平顯著高于對照組（P<0.05）。治療后，兩組CD3⁺、CD4⁺、和CD4⁺/CD8⁺水平均高于本組治療前（P<0.05）；治療后，觀察組CD3⁺、CD4⁺和CD4⁺/CD8⁺水平高于對照組（P<0.05）。結(jié)論 在足月新生兒EOS早期補充維生素D，能提高血清25（OH）D水平并改善患兒炎癥因子水平及細胞免疫功能。

Objective To investigate the effects of early vitamin D supplementation on serum 25(OH)D levels, inflammatory factors, and immune function in neonates with early onset sepsis (EOS). Methods A total of 120 full-term EOS newborns admitted to the Pediatric Intensive Care Unit of The First People's Hospital of Yibin from January 2016 to January 2019 were selected as the research objects. All the infants were divided into a control group and observation group according to the random number table method, with 60 patients in each group. Children in the control group were given active anti-infection, improved ventilation, appropriate hemodynamic support, viscera protection, nutritional support, symptomatic treatment, etc. The children in the observation group were po administered with Vitamin D Drops on the 3rd day after birth on the basis of the control group, 400 IU/d, and took 14 d continuously. The clinical efficacy in two groups was observed, and the levels of 25(OH)D, IL-6, TNF-α, LL-37, and IgM, IgG, and T lymphocyte subsets before and after treatment were compared. Results The effective rate of the observation group was 86.67%, which was significantly higher than 66.67% of the control group, and the difference between two groups was statistically significant (P<0.05). After treatment, the level of 25(OH)D in the observation group was significantly higher than that before treatment (P<0.05), and the level of 25(OH)D in the observation group was significantly higher than that in the control group (P<0.05). After treatment, the levels of CD3⁺, CD4⁺, and CD4⁺/CD8⁺ in two groups were higher than those before treatment (P<0.05). After treatment, the levels of CD3⁺, CD4⁺ and CD4⁺/CD8⁺ in the observation group were higher than those in the control group (P<0.05). Conclusion Vitamin D supplementation at the early stage of EOS in full-term neonates can improve serum 25(OH) D levels and inflammatory cytokines and cellular immune function.

R977.2