Effects of different doses of vitamin D combined with budesonide in preventing bronchopulmonary dysplasia in premature infants
SONG Huanqing
LI Jingjing
FENG Xiaoxia
LIU Yuanyuan
HUO Zhifang
SI Ranran
ZHOU Chuan
Abstract：Objective To explore the effects of different doses of vitamin D combined with early budesonide neb-ulization to prevent bronchopulmonary dysplasia(BPD)in premature infants and its influences on serum 25-hydroxyvitamin D(25-(OH)D)and vitamin D-binding protein(DBP).Methods A total of 350 high-risk premature infants admitted to Pediatric Intensive Care Unit of the Second Affiliated Hospital of Zhengzhou University between January 2019 and October 2024 were enrolled as the research objects.According to different doses of vitamin D,participants were divided into the low-dose group(120 cases,treated with 400 IU vitamin D combined with budesonide aerosol inhalation),the medium-dose group(120 cases,treated with 800IU vitamin D combined with budesonide aerosol inhalation)and the high-dose group(110 cas-es,treated with 1200IU vitamin D combined with budesonide aerosol inhalation),and the treatment lasted for 4 weeks.The incidence and severity of BPD were compared among the three groups at a corrected gestational age of 36 weeks or at discharge.The respiratory support parameters(fraction of inspired oxygen(FIO2),respiratory rate(RR),peak inspira-tory pressure(PIP)),serological indicators(25-(OH)D,DBP),inflammatory factors(interleukin-6(IL-6),procalcitonin(PCT),tumor necrosis factor α(TNF-α))before and after treatment in the three groups were observed.The incidence of adverse reactions in the three groups was statistically analyzed.Results At a corrected gestational age of 36 weeks or hospital discharge,the incidence of BPD in medium-dose group and high-dose group was 13.33%(16/120)and 10.00%(11/110),lower than that in low-dose group(25.83%(31/120).Among infants who developed BPD,the proportion of mild BPD in high-dose group was 63.64%(7/11),higher than that in low-dose group(19.35%(6/31))and medium-dose group(37.50%(6/16)),and the differences were statistically significant(χ2=11.792,Z=10.771,both P<0.05).After treatment,FIO2,RR and PIP were decreased in the three groups,and the high-dose group((21.35±4.15)%,(35.18±3.10)times/min,(19.59±1.06)cmH2O(1 cmH2O=0.098 kPa))and medium-dose group((21.53±5.11)%,(35.46±2.86)times/min,(19.68±1.37)cmH2O)than those in the low-dose group((28.43±4.06)%,(39.57±3.06)times/min,(21.41±1.32)cmH2O),and the differences were statistically significant(F=96.178,78.848,77.900,all P<0.05).After treatment,the levels of 25-(OH)D and DBP in the three groups of premature infants were increased,and the indicators in the high-dose group((31.65±3.56)ng/mL,(479.66±31.69)μg/mL)were both higher than those in the low-dose group((28.45±3.67)ng/mL,(413.44±30.73)μg/mL)and the medium-dose group((29.68±4.11)ng/mL,(448.69±38.64)μg/mL),and the differences were statistically significant(F=20.663,109.732,both P<0.05).After treatment,the levels of IL-6,PCT and TNF-α in the three groups were decreased,and the indica-tors in the high-dose group((4.83±0.51)pg/mL,(0.28±0.07)mg/mL,(14.86±3.18)pg/mL)were lower than those in the low-dose groups((6.12±0.49)pg/mL,(0.46±0.13)mg/mL,(19.66±4.06)pg/mL)and the medium-dose group((5.15±0.37)pg/mL,(0.37±0.08)mg/mL,(16.59±4.11)pg/mL),and the differences were statistically significant(F=249.616,97.626,46.832,all P<0.05).There was no significant difference in the incidence of adverse reactions among the three groups(χ2=3.857,P>0.05).Conclusion High-dose vitamin D combined with early budesonide nebulization can effectively improve the respiratory function of premature infants,reduce the levels of inflammatory factors,thus alleviating their condition and reducing the incidence of BPD.
Keywords：premature infantbronchopulmonary dysplasiabudesonideserum 25-hydroxyvitamin dvitamin d-binding proteinlung function
Publication Date：2025-11-25
Online Publishing Date：2025-12-04(First online date of this platform, not the publication date of the document)
Pages：5( 1437-1441 )