本文選題：25-羥維生素D + 疾病嚴(yán)重程度�。� 參考：《新疆醫(yī)科大學(xué)》2017年碩士論文

【摘要】：目的:討論P(yáng)ICU患兒血清25-羥維生素D水平是否較正常體檢兒血清25-羥維生素D水平低。探討血清25-羥維生素D水平對(duì)膿毒癥患兒的病情嚴(yán)重程度和預(yù)后的影響。方法:通過(guò)臨床回顧性研究分析2014年12月-2016年12月期間在新疆醫(yī)科大學(xué)第一附屬醫(yī)院PICU確診并治療的125例膿毒癥患兒進(jìn)行回顧性研究。檢測(cè)血清25(OH)D水平、血白細(xì)胞(WBC)、降鈣素原(PCT)、白介素6(IL-6)、超敏C反應(yīng)蛋白(CRPH),活化部分凝血活酶時(shí)間(APTT)、凝血酶原時(shí)間(PT)、谷草轉(zhuǎn)氨酶(AST)、谷丙轉(zhuǎn)氨酶(ALT)、血沉(ESR),并記錄小兒危重癥評(píng)分(PCIS評(píng)分)。首先,將在我院收集的125例膿毒癥患兒同同時(shí)期就診我院門診體檢的50例正常體檢兒血清25-羥維生素D水平進(jìn)行比較,得出結(jié)論為PICU患兒的25-羥維生素D水平低于健康對(duì)照。然后根據(jù)血清25(OH)D水平將患兒分為充足組(≥75mmol/L)、不足組(50~75mmol/L)、缺乏組(50mmol/L),進(jìn)行組間比較;其次以患者28天轉(zhuǎn)歸情況為終點(diǎn),再對(duì)生存組與死亡組進(jìn)行比較。用Logistic回歸分析確定影響預(yù)后的獨(dú)立因素。結(jié)果:維生素D缺乏組、不足組、充足組患兒分別為75例(60%)、40例(32.0%)、10例(8%)。三組間兩兩比較顯示,缺乏組的病死率(37.3%)比不足組(7.5%)和充足組(0%)明顯升高(P0.05),缺乏組的嚴(yán)重膿毒癥和膿毒癥休克患者比例及PCIS評(píng)分顯著高于充足組(P0.05)。生存組(94例)與死亡組(31例)間比較,25(OH)D水平、PCIS評(píng)分、PCT和CRPH的差異有統(tǒng)計(jì)學(xué)意義(P0.05),25(OH)D水平和PCIS評(píng)分是膿毒癥患者28天病死率的獨(dú)立影響因素。結(jié)論:PICU患兒的25-羥維生素D水平低于健康對(duì)照。血清25(OH)D水平的降低可能加重膿毒癥患者的病情、增加死亡風(fēng)險(xiǎn),影響患者預(yù)后。
[Abstract]:Objective: to investigate whether the serum 25-hydroxyvitamin D level in children with PICU is lower than that in normal children. To investigate the effect of serum 25-hydroxyvitamin D level on the severity and prognosis of sepsis children. Methods: from December 2014 to December 2016, 125 children with sepsis diagnosed and treated by PICU in the first affiliated Hospital of Xinjiang Medical University were retrospectively analyzed. The levels of serum 25(OH)D, serum WBCU, procalcitonin, interleukin-6 (IL-6), hyper-sensitive C-reactive protein (25(OH)D), activated partial thromboplastin time (APTTT), prothrombin time (PTT), aspartate aminotransferase (alt), alanine aminotransferase (alt), erythrocyte sedimentation rate (ESR) were measured. Firstly, the serum levels of 25-hydroxyvitamin D in 125 septic children collected in our hospital were compared with those in 50 normal children at the same time. It was concluded that the level of 25-hydroxyvitamin D in children with PICU was lower than that in healthy controls. Then the children were divided into sufficient group (鈮，

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