摘要目的 比较新生儿不同时期血清维生素D 对缺氧缺血性脑病的诊断价值。 方法 回顾性分析2017年5月至2019年5月新疆生产建设兵团第二师库尔勒医院出生/娩出的90 例新生儿的临床资料，将健康新生儿作为对照组（n=45），将缺血缺氧性脑病患儿作为观察组（n=45）。通过酶联免疫法对两组出生后1、7 d 的维生素D 水平进行分析，比较两组的维生素D 缺氧缺血性脑病诊断临界值、诊断的曲线下面积等。结果 观察组出生后1、7 d 的维生素D 水平低于对照组，差异有统计学意义（P＜0.05）。观察组出生后7 d 的维生素D 水平低于对照组，差异有统计学意义（P＜0.05）。出生后1 d 时的曲线下面积为0.681，出生后7 d 时的曲线下面积为0.703，出生后7 d 的曲线下面积优于出生后1 d，差异有统计学意义（Z=1.940，P=0.021）。出生后7 d 的临界值为21.5 mmol/L，出生后1 d 的临界值为22.5 mmol/L。当出生后1 d 的维生素D 水平不超过22.5 mmol/L 时，对疾病诊断的特异度及敏感度分别为69.9%、66.7%。当出生后7 d 的维生素D 水平在21.5 mmol/L 以下时，对疾病诊断的特异度及敏感度分别为73.3%、80.0%。结论 维生素D 对于新生儿缺血缺氧性脑病诊断具有较高价值，发病时间越长，维生素D 的诊断价值越高。
Abstract：Objective To compare the value of serum vitamin D in different stages of newborns in the diagnosis of hypoxic-ischemic encephalopathy. Methods The clinical data of 90 newborns who was born or delivered in Korla Hospital of the Second Division of Xinjiang Production and Construction Corps from May 2017 to May 2019 were analyzed retrospectively. Healthy newborns were involved as the control group (n=45), and newborns with hypoxic-ischemic encephalopathy were involved as the observation group (n=45). The levels of vitamin D in the two groups were analyzed by enzyme-linked immunosorbent assay at 1 and 7 d after birth. The critical value and the area under the curve of vitamin D in diagnosis of hypoxic-ischemic encephalopathy were compared between the two groups. Results The serum level of vitamin D in the observation group at 1 and 7 d after birth were lower than those in the control group, with statistically significant differences (P＜0.05). The level of vitamin D in the observation group at 7 d after birth was lower than that in the control group, with statistically significant difference (P＜0.05). The area under the curve at 1 and 7 d after birth were 0.681 and 0.703, respectively. The area under the curve at 7 d after birth was better than that at 1 d after birth, with statistically significant difference (Z=1.940, P=0.021). The critical value at 1 and 7 d after birth were 22.5 mmol/L and 21.5 mmol/L,respectively.When the level of vitamin D at 1 d after birth did not exceed 22.5 mmol/L,the specificity and sensitivity of the disease diagnosis were 69.9% and 66.7%, respectively. When the vitamin D level at 7 d after birth was below 21.5 mmol/L, the specificity and sensitivity of disease diagnosis were 73.3% and 80.0%,respectively. Conclusion Vitamin D has high value in the diagnosis of neonatal hypoxic-ischemic encephalopathy. The longer the onset time, the higher the diagnostic value of vitamin D.
李洪波；山其米克；徐娟；徐晶. 新生儿不同时期血清维生素D对缺氧缺血性脑病诊断价值比较[J]. 中国当代医药, 2021, 28(30): 127-129.
LI Hong-bo SHAN Qi-mi-ke XU Juan XU Jing. Comparison of value on serum vitamin D in different stages of newborns in the diagnosis of hypoxic-ischemic encephalopathy. 中国当代医药, 2021, 28(30): 127-129.
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