中国妇幼健康研究2024，Vol.35Issue(4)：90-96,7.DOI:10.3969/j.issn.1673-5293.2024.04.014
维生素D与儿童脓毒症免疫及预后的相关性分析
Analysis of relationships of vitamin D with immunity and prognosis of children with sepsis
摘要
Abstract
Objective To survey serum level of vitamin D in children with sepsis and to explore relationships of vitamin D with immunity and prognosis of the children with sepsis.Methods The serum levels of vitamin D of 63 children with sepsis(divided into sepsis group)and 53 non-septic children(in the same period,divided into non-sepsis group)who hospitalized in Pediatric Intensive Care Unite(PICU)of Hebei Provincial Children's Hospital from December 2021 to November 2022 were detected.The difference in serum level of vitamin D of the children between the two groups,and correlations of serum vitamin D level with immune indexes(lymphocyte subsets and immunoglobulin)of the children with sepsis were analyzed.Logistic regression analysis was used to screen risk factors for mortality of the children with sepsis,and ROC curve was used to evaluate prognostic values of these risk factors for the children with sepsis.Results ①The serum level of vitamin D of the children in the sepsis group was lower than that in the non-sepsis group(Z=-5.740,P＜0.05).②Correlation analysis showed that the serum level of vitamin D of the children in the sepsis group was positively correlated with total T lymphocytes(CD3+),helper T lymphocytes(CD4+)and CD4+/CD8+ratio(r=0.308,0.264 and 0.272 respectively,all P＜0.05).③Univariate analysis showed that the serum vitamin D level,pediatric critical illness score(PCIS),pediatric sequential organ failure assessment(PSOFA)score,serum lactate(LAC)level and CD4+/CD8+ratio were the influencing factors of mortality of the children with sepsis(Z/t=-4.138,-4.390,-4.582,-3.000 and-2.282 respectively,all P＜0.05).Logistic regression analysis shown that the serum vitamin D level and PCIS score were independent risk factors for 28-day death in sepsis(OR=0.732,95％CI:0.540-0.993,P=0.045;OR=0.785,95％CI:0.642-0.960,P=0.019).The AUC of combination of vitamin D and PCIS score was 0.941(95％CI:0.886-0.995),and when the cutoff value was determined at 0.226,the sensitivity was 94.4％and the specificity was 84.4％.Conclusion Vitamin D deficiency affects immune function of the children with sepsis.Serum vitamin D level is an independent risk factor for predicting 28-day death in children with sepsis.The combination of serum vitamin D level and PCIS score can improve the predictive value for 28-day death in children with sepsis.关键词
儿童/脓毒症/维生素D/免疫/预后Key words
children/sepsis/vitamin D/immunity/prognosis分类
医药卫生引用本文复制引用
刘亚平,徐梅先,高蕾,白新凤,闫玉洁..维生素D与儿童脓毒症免疫及预后的相关性分析[J].中国妇幼健康研究,2024,35(4):90-96,7.基金项目
河北省重点研发计划项目(182777133) （182777133）
河北省政府资助临床医学优秀人才培养项目计划 （）
