目的 探讨早期补充维生素D对早发型败血症（EOS）新生儿的血清25羟维生素D[25（OH）D]水平、炎症因子及免疫功能的影响。方法 选取2016年1月-2019年1月宜宾市第一人民医院儿童重症监护病区收治的EOS的足月新生儿120例为研究对象，所有患儿按照随机数字表法分为对照组和观察组，每组各60例。对照组患儿予以积极抗感染，改善通气，适当的血流动力学支持，保护脏器，营养支持，对症治疗等；观察组患儿在对照组的基础上于出生后第3天开始口服维生素D滴剂，400 IU/d，连续服用14 d。观察两组患者的临床疗效，同时比较两组治疗前后的25（OH）D、白细胞介素-6（IL-6）、肿瘤坏死因子-α（TNF-α）、抗菌肽-37（LL-37）水平，以及免疫球蛋白（Ig）M、IgG和T淋巴细胞亚群指标水平。结果 观察组的有效率为86.67%，明显高于对照组的66.67%，两组有效率比较差异有统计学意义（P<0.05）。治疗后，观察组25（OH）D水平显著高于本组治疗前（P<0.05），且治疗后，观察组25（OH）D水平显著高于对照组（P<0.05）。治疗后，两组CD3⁺、CD4⁺、和CD4⁺/CD8⁺水平均高于本组治疗前（P<0.05）；治疗后，观察组CD3⁺、CD4⁺和CD4⁺/CD8⁺水平高于对照组（P<0.05）。结论 在足月新生儿EOS早期补充维生素D，能提高血清25（OH）D水平并改善患儿炎症因子水平及细胞免疫功能。

Objective To investigate the effects of early vitamin D supplementation on serum 25(OH)D levels, inflammatory factors, and immune function in neonates with early onset sepsis (EOS). Methods A total of 120 full-term EOS newborns admitted to the Pediatric Intensive Care Unit of The First People's Hospital of Yibin from January 2016 to January 2019 were selected as the research objects. All the infants were divided into a control group and observation group according to the random number table method, with 60 patients in each group. Children in the control group were given active anti-infection, improved ventilation, appropriate hemodynamic support, viscera protection, nutritional support, symptomatic treatment, etc. The children in the observation group were po administered with Vitamin D Drops on the 3rd day after birth on the basis of the control group, 400 IU/d, and took 14 d continuously. The clinical efficacy in two groups was observed, and the levels of 25(OH)D, IL-6, TNF-α, LL-37, and IgM, IgG, and T lymphocyte subsets before and after treatment were compared. Results The effective rate of the observation group was 86.67%, which was significantly higher than 66.67% of the control group, and the difference between two groups was statistically significant (P<0.05). After treatment, the level of 25(OH)D in the observation group was significantly higher than that before treatment (P<0.05), and the level of 25(OH)D in the observation group was significantly higher than that in the control group (P<0.05). After treatment, the levels of CD3⁺, CD4⁺, and CD4⁺/CD8⁺ in two groups were higher than those before treatment (P<0.05). After treatment, the levels of CD3⁺, CD4⁺ and CD4⁺/CD8⁺ in the observation group were higher than those in the control group (P<0.05). Conclusion Vitamin D supplementation at the early stage of EOS in full-term neonates can improve serum 25(OH) D levels and inflammatory cytokines and cellular immune function.

R977.2