Correlation Between Children Serum Levels Of 25-hydroxyvitamin D And Sepsis

New definition of sepsis-3 promulgated in 2016,and was publised in the American of Medicine.Sepsis is now defined as life-threatening organ dysfunction caused by a dysregulated host response to infection.The main development machanism mainly includes the following two aspects:one is systemic immunity-inflammatory reaction out of control;The second is the microecological mechanism of infection.In the recent years,some progress has been made in the treatment of sepsis and septic shock.However,the mortality rate is still high.The mental and fianacial burden on children and families.Due to the high morbidity and mortality rate of sepsis,research related to this disease has been in a relatively active field.Objective:Analysis of the relationship between 25-hydroxyvitamin D levels of children and sepsis.To assess the relationship between the occurrence,development and prognosis of sepsis and 25-hydroxyvitamin D levels.This provides a theoretical basis for the assessment of sepsis,early intervention and improvement of prognosis.Methods:To collect 142 sepsis cases from November 2016 to November 2018 in the pediatric intensive care unit of Affiliated Hospital Of Chengde Medical University.Detection of 25（OH）D levels,blood leukocyte count（WBC）,calcitonin（PCT）,C-reactionprotein（CRP）,part activated clotting time live enzymes（APTT）,Prothrombin time（PT）,microbiological culture and critically ill children score（PCIS score）.50 cases of children who were examined in our hospital during the same period.Detection of 25（OH）D₃levels.The frist,analysis of the levels of 25-hydroxyvitamin D in healthy children and children with sepsis.The second,according to vitamin D level divided into three groups:the normal group、the insufficient and lack of.Analysis of the clinical data in these groups and 28-day mortality.Using Logistic regression analysis to determine the independent factors affecting the prognosis.Using 28 days as the end of the study,the group was divided into survival group and death group according to the children with sepsis.The levels of 25-hydroxyvitamin D were compared between the two groups.Results:1.The average level of 25（OH）D in sepsis group was significantly lower than that in healthy group,the difference was statistically significant（P<0.001）.2.To be lack of vitamin D deficiency group,the group,adequate chi ldren of 78cases（54.9%）,39cases（27.5%）,25cases（17.6%）respectively.With 28 days as the end of the study,the total number of deaths was23 cases（16.1%）.Two comparison between the three groups,the lack of a group of patients with sepsis PCIS score is significantly lower th an group（P<0.001）.Survival group 117 cases of comparision between group of 23 cases with death,hydroxyl vitamin D levels is lower.That was statistically significant.（P<0.001）.3.Using Logistic analysis to determine the independent factors affecting the prognosis.4.25（OH）D concentrations are lower in sepsis patients with positive microbial culture.Conclusion:25（OH）D deficiency is an important risk factor for sepsis.Low lev els of vitamin D in microbiological positive culture group;Serum 25-hy droxyvitamin D was correlated with PCIS score（pediatric critical illnes s score）,and 25-hydroxyvitamin D was used as an indicator to assess the severity of sepsis;There is a significant negative correlation betwee n serum 25-hydroxyvitamin D levels and mortality.Therefore,25-hydro xyvitamin D is one of the factors affecting the prognosis of children with sepsis.