孕妇与婴幼儿维生素D缺乏研究性进展综述模板.doc

孕妇与婴幼儿维生素D缺乏的研究性进展 浙江大学医学部 庄学玲 邵洁 儿科学 综述 审校 摘要:维生素D是一种脂溶性类固醇衍生物，因其主要来源于皮肤中7一脱氢 胆固醇经波长290}315nm的紫外线B照射转变而来，故又被称为“阳光维生素”。 近年来，研究发现维生素D除具有经典的调节钙磷平衡和维持骨骼健康的作用外， 还具有其他更为广泛的骨骼外生物学效应，如调节免疫、抗肿瘤、保护中枢神经 系统和防控代谢综合征等作用。孕妇与婴幼儿由于特殊的生理特点而成为维生素D 缺乏的高危人群。妊娠期间，尤其在孕晚期25-(OH)D能通过胎盘转运给胎儿，是 新生儿维生素D储备的主要来源。因此孕妇维生素D缺乏不仅影响自身健康，对 其后代的健康状况也会产生长远影响。 关键词:孕妇;婴幼儿;维生素D Progress of Mother-Infant Vitamin D Deficiency Research ZHUANG Xue-ling SHAO Jie Department of Pediatrics Health Care. The Childrens Hospital of Zhejiang University School of Medicine. Hangzhou 310003, China. Corresponding author: Shao Jie (Email: shaojie@) ABCTRACT: Vitamin D is a fat-soluble secosteroids. More than 90% vitamin D is derived from the skin after exposure to ultraviolet B (290-315nm), so its also called sunshine vitamin. In recent years, in addition to rickets arzd other possible consequences of disturbed calcium homeostasis, studies suggested important extra- skeletal function of vitamin D on the immune system and in preventing cancers, protecting the development of nerve system and protecting against metabolic syndrome. Pregnant women and infants were in high risk of vitamin D deficiency due to the special physical status. During pregnancy, especially in the third trimester, 25一(OH)D can readily cross the placenta from the mother to the foetus. So vitamin D deficiency during pregnancy can not only cause adverse impact on maternal health but also impairs foetus development and has long effect on their offsprings. Key words: Pregnant women; Infant; vitamin D 维生素D缺乏性询楼病是婴幼儿常见的营养性疾病。维生素D缺乏不仅影响 小儿骨骼发育，导致骨质软化，骨骼畸形，同时影响神经，肌肉，造血，免疫等 组织器官的功能，易患上感，肝炎，腹泻，贫血等疾病，严重影响小儿健康。从 二十世纪早期，人们发现维生素D和充足的阳光能够预防和治疗询楼病，并开始 应用维生素D增剂和婴幼儿维生素D强化食物等一些干预措施，维生素D缺乏性 拘楼病发病率明显下降。但由于儿童生长发育的特殊性，儿童维生素D缺乏和营 养性拘楼病仍然非常常见。维生素D缺乏可能不仅是由于婴幼儿期获得维生素D 不足，更可能是由于胎儿时期从母体获得的维生素D储备不足导致或者单一以母 乳为饮食来源的原因[Ul。近年来研究发现孕期维生素D缺乏导致胎儿出生后维生 素D缺乏，不仅影响小儿骨骼肌肉的发育，还与小儿呼吸道感染，T1 DM，炎症 性肠道疾病，精神性疾病如双相情感障碍，精神分裂症等的发生有关[2,