Study On Bone Metabolism Level And Relationship Between Vitamin D And Early-onset Sepsis In Very Low Birth Weight Infants

Objective:To collect The clinical data in very low birth weight infants,understand the very low birth weight infants 25-hydroxy vitamin D,serum calcium,phosphorus,alkaline phosphatase,and explore its relationship with early onset sepsis.To provide basis for clinical understanding of bone metabolism in very low birth weight infants and early prevention and treatment of early onset sepsis.Methods:This study used retrospective clinical investigation and analysis methods.A total of 216 very low birth weight infants were admitted to the neonatal intensive care unit of the First Affiliated Hospital of Kunming Medical University between January 2014 and December 2016.Based on the occurrence of early-onset sepsis,the group was divided into early onset sepsis group and non early sepsis group.According to gestational age,<32 weeks group and more than 32 weeks were divided.The statistics indude gestational age,birth weight,gender,25-hydroxy vitamin D,serum calcium,phosphorus and alkaline phosphatase,blood routine,C reactive protein value.T test was used to fit normal distribution data,U test was used for non normal distribution data and chi square test was used to compare enumerati on dataResults:1.216 cases of very low birth weight infants changes of bone metabolism:25-hydroxy vitamin D after birth and 3 weeks were 35.47 + 13.89 and 50 + 12.9 nmol/L;calcium after birth and 3 weeks were 2.12 + 0.37 and 2.31 + 0.28mmol/L;phosphorus after birth and 3 weeks were 1.65 + 0.68,2.81+ 0.43mmol/L;alkaline phosphatase after birth and 3 weeks was 191.40 + 70.78 IU/L 285.14 + 103.00IU/L;25-hydroxy vitamin D and alkaline phosphatase was statistically significant at 3 weeks after birth and the difference(P<0.05).2.Different gestational age of very low birth weight infants changes of bone metabolism:<32 weeks after birth and 3 weeks,25-hydroxy vitamin D,calcium,phosphorus,alkaline phosphatase were 30 + 14.4 nmol/L,2.08 ?0.7 mmol/L,1.67 + 0.96 mmol/L,209 + 101.6 IU/L growth to 41.05 ?14.6 nmol/L and 2.34 + 0.29 mmol/L,2.07 ±0.42mmol/L,271.1 + 90 IU/L;25-hydroxy vitamin D,calcium,phosphorus,alkaline phosphatase were statistically significant at 3 weeks after birth and the difference(P<0.01);25-(OH)D deficiency rate after birth and 3 weeks respectively for 89.1%,80.9%;Over 32 weeks with very low birth weight infants changes of bone metabolism:after birth and 3 weeks of 25-hydroxy vitamin D and calcium,phosphorus and alkaline phosphatase were from postnatal 40.3 ± 22 nmol/L,2.27 ± 0.55mmol/L,1.48±0.89 mmol/L,177 ±72 IU/L growth t049.4 + 11.8 nmol/L,2.30 + 0.26mmol/L,1.9 + 0.47mmol/L,294 + 110 IU/L;25-hydroxy vitamin D,calcium,phosphorus,alkaline phosphatase was statistically significant at 3 weeks after birth and the difference(P<0.05);25-hydroxy vitamin D defidency rate after birth and 3 weeks respectively for 81.1%,59.4%.3.Very low birth weight infants of different gestational age of bone metabolism level:less than 32 weeks,over 32 weeks after birth 25-hydroxy vitamin D,calcium,phosphorus and alkaline phosphatase were 30± 14.4 nmol/L?40.3±22nmol/L,2.08 + 0.7 mmol/L.2.27 + 0.55mmol/L,1.67 ±0.96 mmol/L?1.48 ±0.89mmol/L,209 ±101.6 I U/L?177 ±72I U/L,different gestational age of very low birth weight infants born when serum 25-hydroxy vitamin D,calcium,phosphorus and alkaline phosphatase had significant difference(P<0.05);The different gestational age of 3 weeks of bone metabolism le\vel:less than 32 weeks,over 32 weeks in group 25-hydroxy vitamin D and calcium,phosphorus and alkaline phosphatase were 41.05 ±14.6 nmol/L?49.4 ±11.8nmol/L,2.34 ± 0.29 mmol/L?2.30 ± 0.26mmol/L,2.07 ± 0.42 mmol/L?1.9 ± 0.47 mmol/L,271.1 ± 90 IU/L?294 ± 110 IU/L,3 week in different gestational age of very low birth weight infants serum 25-hydroxy vitamin D was statistically significant(P<0.05).4.Very low birth weight infants with vitamin D levels and early onset sepsis:216 cases of very low birth weight infants,early onset sepsis group 73 cases,non early onset sepsis group of 143 cases,patients with early onset sepsis group,vitamin D levels,non early onset sepsis group level of vitamin D were 31.25 ± 14.70 nmol/L?31.25 ± 14.70nmol/L,and there are significant differences in vitamin D levels in the two groups(P<0.05);In the blood culture positive group,the vitamin D level was 34.98 + 15.21nmol/L in the early onset sepsis group,the serum vitamin D level was 35.6 + 14.27nmol/L in the blood culture negative early sepsis group,and there was no significant difference between the two groups(P>0.05).Conclusion(s):1.Vitamin D deficiency is prevalent in very low birth weight infants,and is still in short supply st 3 weeks.Less than 32 weeks,In very low birth weight infants,25 hydroxyvitamin D deficiency are more serious.2.Less than 32 weeks,very low birth weight infants were born with lower levels of clcium,phosphorus and alkaline phosphatase were relatively high.3.25-hydroxy vitamin D and alkaline phosphatase are sensitive indicators of bone metabolism in very low birth weight infarrts.4.low levels of vitami'n D are associated with the occurrence of early-onset sepsis in very low birth weight infanta.