| Objective: To estimate the 25-hydroxy-vitamin D(25-(OH)D)and vitamin D binding protein(VBDP)levels in critically ill children in pediatric intensive care unit(PICU),and to examine its relationship with outcomes.Methods: We enrolled 295 children admitted to PICU of The First Affiliated Hospital of Guangxi Medical University between February 2015 and August 2016 as the study group;Collected 44 cases of normal children in outpatient department of Pediatrics of the First Affiliated Hospital of Guangxi Medical University during the same period as control group.The children in the study group were given 2 2ml blood samples in the first day and the seventh day.The serum levels of 25-(OH)D were detected by electrochemiluminescence assay and the serum levels of VDBP were detected by enzyme-linked immunosorbent assay(ELISA).So do the control group.According to the 25-(OH)D level,the patients were divided into 25-(OH)D adequate group,25-(OH)D insufficient group,and 25-(OH)D deficiency group.Analyzed and compared the study group and the control group 25-(OH)D and VDBP levels.The level of 25-(OH)D and VDBP were analyzed with theirmajor systemic diseases in the study group.The relationship between25-(OH)D level and VDBP level,age,serum total calcium,BMI,PRISM III,organ failure rate,mechanical ventilation rate and twenty-eighth day mortality were analyzed in the study group and the differences in 25-(OH)D level,VDBP level and PRISM III of 25-(OH)D between the first and seventh days were analyzed;The differences of 25-(OH)D,VDBP,PRISM III between PICU survival and death group were analyzed.Results:(1)A total of 295 cases of critically ill children in the study group,including: male(n = 175,59.3%)and female(n = 120,40.7%),the median age of the patients was 1.5 years.The control group of 44 cases of normal children,including: male(n = 23,52.3%),female(n =21,47.3%),the median age of the patients was 3.0years,there was no significant difference between the two groups(P > 0.05).(2)There was no significant difference in25-(OH)D deficiency and VDBP level low(P >0.05).(3)Compared with the control group,the levels of 25-(OH)D and VDBP were lower in the study group,and the difference was statistically significant(P < 0.05).(4)In the study group,there was no significant difference in serum total calcium,VDBP,BMI,28 th day mortality,organ failure rate,and mechanical ventilation rate between 25-(OH)D(P >0.05)in the group with adequate group,deficient group and deficiency group,the deficiency group was oldest and lived longest in PICU,highest marks PRISM III,the difference was statistically significant(P < 0.05).(5)Check PICU 1st day and 7th day 25-(OH)D/VDBP level lower,the PRISM III higher,the difference was statistically significant(P<0.05).(6)In 295 cases of critically ill children,the survival of 28 th day in257 cases(87.1%),38 cases of death(12.9%),deaths compared with the survival group,the 25-(OH)D levels lower and PRISM III higher,thedifference was statistically significant(P < 0.05),no significant differences in death and survival group VDBP level(P > 0.05).Conclusions:(1)The data suggest that there are 25-(OH)D/VDBP levels insufficient or deficiency in critically ill children,especially in sepsis or MODS and surgical disease in children.(2)25-(OH)D/VDBP levels insufficient or deficiency children have higher PRISM III,live longer in PICUand high mortality rate of 28 th day.(3)Critically ill children with the improvement of the disease,PRISM III score decreased,25-(OH)D and VDBP levels increased. |
