| Objectives:To understand the serum VA level of premature infants with different gestational age,different birth weight,different fetal number and sepsis,And the correlation between the level of serum VA deficiency and sepsis in premature infants.To provide reference for prevention and treatment of serum VA deficiency in premature infants,especially those suffering from sepsis.Methods:According to the inclusion criteria of this study,165 cases of premature infants hospitalized in the Department of Neonatology of the Second Affiliated Hospital of Kunming Medical University from January 2019 to August 2020 were selected as the study subjects.According to the gestational age stage,birth weight stage,the number of fetuses and whether they had sepsis were divided into groups.Fasting whole blood samples of 2ml were collected within 24 hours of admission.Serum was centrifuged within 24 hours under cold storage at 0～4℃ and in dark environment.The serum VA level was determined by High Performance Liquid Chromatography(HPLC).Excel was used to collect and sort out the general clinical data of the children and the obtained data,and SPSS 25.0 statistical software was used for statistical analysis.Results:1.165 cases of preterm infants overall serum VA level:normal 2 cases(1.2%),marginal type deficiency 33 cases(20%),subclinical type deficiency 111 cases(67.2%),clinical type deficiency 19 cases(11.5%),the rate of serum VA deficiency was 78.7%.2.Comparison of the relationship between serum VA level and gestational age in premature infants.There were 22 cases of very premature infants,including 1 case(4.5%)with normal serum VA,2 cases(9.1%)with marginal deficiency,15 cases(68.2%)with subclinical deficiency,and 4 cases(18.2%)with clinical deficiency.There were 21 cases of moderate premature infants.The serum VA level was normal in 0 cases(0%),marginal deficiency in 6 cases(28.6%),subclinical deficiency in 13 cases(61.9%),and clinical deficiency in 2 cases(9.5%).There were 122 cases of late preterm infants,including 1 case(0.8%)with normal serum VA level,15 cases(20.5%)with marginal type deficiency,83 cases(68.0%)with subclinical type deficiency,and 13 cases(10.7%)with clinical type deficiency.There was no statistical significance between the two groups(P=0.401),suggesting that the degree of serum VA deficiency in preterm infants was not related to gestational age.3.Comparison of the relationship between serum VA level and birth weight in premature infantsThere were 34 cases of small for gestational age.The serum VA level was normal in 0 cases(0.0%),marginal deficiency in 1 case(2.9%),subclinical deficiency in 24 cases(70.6%),and clinical deficiency in 9 cases(26.5%).A total of 125 children of suitable gestational age had normal serum VA levels in 2 cases(1.6%),marginal deficiency in 17 cases(21.6%),subclinical deficiency in 86 cases(68.8%),and clinical deficiency in 10 cases(8.0%).There were 6 children older than gestational age.The serum VA level was normal in 0 cases(0.0%),marginal deficiency in 5 cases(15.2%),subclinical deficiency in 1 case(0.9%),and clinical deficiency in 0 cases(0.0%).The comparison between groups was statistically significant(P<0.01),suggesting that the serum VA deficiency of premature infants decreased with the increase of birth weight.4.Comparison of the relationship between serum VA level and gestational age of premature infantsThere were 106 cases of single premature infants,including 1 case(0.9%)with normal serum VA,28 cases(26.4%)with marginal deficiency,72 cases(67.9%)with subclinical deficiency,and 5 cases(4.7%)with clinical deficiency.A total of 59 premature twins had normal serum VA level in 1 case(1.7%),marginal deficiency in 5 cases(8.5%),subclinical deficiency in 39 cases(66.1%),and clinical deficiency in 14 cases(23.7%).The comparison between groups was statistically significant(P<0.01),indicating that with the increase of the number of fetuses,the degree of serum VA deficiency in premature infants increases.5.Comparison of serum VA deficiency degree between the sepsis group and non-sepsis group in premature infantsIn the sepsis group,there were 36 patients,including 0 patients(0%)with normal serum VA level,3 patients(8.3%)with marginal deficiency,24 patients(66.7%)with subclinical deficiency,9 patients(25.0%)with clinical deficiency.The serum VA level was(0.12±0.05)mg/L,and the overall rate of serum VA deficiency was 91.7%.In the non-sepsis group,there were 129 cases,including 2 cases(1.6%)with normal serum VA Ievel,30 cases(23.3%)with marginal deficiency,87 cases(67.4%)with subclinical deficiency,and 10 cases(7.8%)with clinical deficiency.The serum VA level was(0.16±0.06)mg/L.The overall rate of serum VA deficiency was 75.2%%.The comparison between the two groups was statistically significant(P=0.013),suggesting that the rate and degree of serum VA deficiency in preterm infants with sepsis were higher than those without sepsis.6.Comparison of serum VA levels of preterm infants with different primary diseases in sepsis group and non-sepsis groupNRDS,pneumonia and NRDS combined with pneumonia were the common primary diseases in the sepsis group and the non-sepsis group.The comparison of serum VA levels showed that:①The serum VA level of preterm infants with NRDS complicated with sepsis was[0.130(0.115,0.150)]mg/L,and that of preterm infants without sepsis was[0.230(0.190,0.270)]mg/L.P=0.028,the difference was statistically significant,suggesting that the serum VA level of premature infants with NRDS complicated with sepsis was lower than that of premature infants without NRDS complicated with sepsis.②The serum VA level of preterm infants with pneumonia complicated with sepsis was[0.135(0.100,0.200)]mg/L,and that of preterm infants without pneumonia complicated with sepsis was[0.140(0.120,0.160)]mg/L.P=0.955,and the difference was not statistically significant,suggesting that there was no difference in serum VA level between premature infants with pneumonia complicated with sepsis and those without pneumonia complicated with sepsis.③The serum VA level of NRDS complicated with pneumonia and sepsis was[0.090(0.065,0.1250)]mg/L,and that of NRDS complicated with pneumonia was[0.140(0.110,0.160)]mg/L.P=0.009,the difference was statistically significant,suggesting that the serum VA level of premature infants with NRDS complicated with pneumonia and sepsis was lower than that of premature infants with NRDS complicated with pneumonia.7.The clinical data and serum VA level of the sepsis group and the non-sepsis group were compared between the two groups.The results showed that the gestational age,birth weight,number of fetuses and serum VA level were statistically significant(P<0.05);Further improved binary Logistics regression analysis showed that gestational age,birth weight and serum VA level were independent risk factors for sepsis in preterm infants,but fetal number was not.Conclusions:1.165 premature infants had a serum VA deficiency rate of 78.7%;The degree of serum VA deficiency had no difference in gestational age,but was negatively correlated with birth weight and positively correlated with the number of fetuses.2.The rate and degree of serum VA deficiency in preterm infants with sepsis were higher than those without sepsis;3.The serum VA level of septicemic preemies with NRDS and NRDS combined with pneumonia as the primary disease was lower than that of non-septicemic preemies.The serum VA level of septicemic preemies with pneumonia as the primary disease was not different from that of non-septicemic preemies.4.Gestational age,birth weight and serum VA level were independent risk factors for septicemic preterm infants,but the number of fetuses was not. |
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