目的 探讨脂溶性维生素A、D、E水平与儿童特应性皮炎(AD)发病及疾病严重程度之间的关系,为临床有效防治儿童AD提供理论依据。方法 2018年3月—2020年3月选取海南医学院第二附属医院皮肤科确诊的AD患儿64例为AD组和同期健康体检儿童64例为对照组,通过SCORAD评分评估AD患儿疾病严重程度,采用高效液相色谱法检测血清维生素A(VitA)和维生素E(VitE)水平,采用液相色谱-串联质谱法检测血清25羟基维生素D3[25(OH)D3]水平。结果 AD组血清VitA和25(OH)D3水平均低于对照组,差异有统计学意义(t=3.986、4.312,P<0.05),AD患儿SCORAD评分为(37.8±15.3)分,轻、中、重度AD患儿血清25(OH)D3水平差异有统计学意义(F=9.405,P<0.05),血清25(OH)D3水平与SCORAD评分呈负相关(r=-0.389,P=0.001),血清VitA和VitE水平与SCORAD评分无相关性(P>0.05)。结论 AD患儿存在VitA、VitD缺乏或不足,血清VitD水平与AD严重程度呈负相关。
Abstract
Objective To investigate the relationship between fat-soluble vitamins (vitamin A,D,E) and the incidence and severity of atopic dermatitis (AD) in children,so as to provide theoretical reference for prevention and treatment of AD in children. Methods A total of 64 AD children diagnosed in the Second Affiliated Hospital of Hainan Medical College were selected as AD group,and 64 healthy children in the same period were recruited into control group.The severity of AD was assessed by the Scoring Atopic Dermatitis (SCORAD).The levels of vitamin A (Vit A) and vitamin E (Vit E) were tested by high performance liquid chromatography,and the level of 25-hydroxy vitamin D3 [25(OH)D3] was determined by liquid chromatography tandem mass spectrometry. Results Compared with control group,the AD group had significantly lower levels of Vit A and Vit E (t=3.986,4.312,P<0.05).The mean SCORAD score of AD children was 37.8±15.3.The difference in serum 25(OH)D3 level among mild,moderate and severe AD groups was significantly different(F=9.405, P<0.05).Among AD children,the SCORAD score was negatively correlated with serum 25(OH)D3 level (r=-0.389,P=0.001),but not related to Vit A and Vit E levels (P>0.05). Conclusion Vit A and Vit D deficiency or insufficiency exists in AD children,and the serum Vit D level is negatively correlated with the severity of AD.
关键词
特应性皮炎 /
脂溶性维生素 /
儿童 /
疾病严重程度指数
Key words
atopic dermatitis /
fat-soluble vitamin /
children /
disease severity index
{{custom_sec.title}}
{{custom_sec.title}}
{{custom_sec.content}}
参考文献
[1] 胡宇晴,张建中.特应性皮炎治疗药物研究进展[J].中华皮肤科杂志,2019,52(1):57-60.
[2] 张珍珍,李萍,严星强.儿童特应性皮炎的流行病学研究现状[J].国际流行病学传染病学杂志,2020,47(2):174-177.
[3] 刘闪闪,朱迅,李冬,等.维生素A缺乏对免疫细胞的影响及其在哮喘中作用的研究进展[J].中国免疫学杂志,2020,36(7):874-877.
[4] Restimulia L,Pawarti DR,Ekorini HM.The relationship between serum vitamin D levels with allergic rhinitis incidence and total nasal symptom score in allergic rhinitis patients[J]. Open Access Maced J Med Sci,2018,6(8):1405-1409.
[5] Williams HC,Chalmers J.Prevention of atopic dermatitis[J]. Acta Derm Venereol,2020,100(12):adv00166.
[6] 中华医学会皮肤性病学分会免疫学组,特应性皮炎协作研究中心.中国特应性皮炎诊疗指南(2020版)[J].中华皮肤科杂志,2020,53(2):81-88.
[7] 郭远,蔡羽恬,郭宁宁,等.特应性皮炎的免疫机制及Dupilumab治疗研究进展[J].中国麻风皮肤病杂志,2018,34(2):125-128.
[8] Sanmartin R,Pardos C,Doste D,et al. The association between atopic dermatitis and serum 25-hydroxyvitamin D in children:Influence of sun exposure,diet,and atopy features-A cross-sectional study[J]. Pediatr Dermatol,2020,37(2):294-300.
[9] Xiang J,Wang H,Li T.Comorbidity of vitamin A and vitamin D deficiency exacerbates the severity of atopic dermatitis in children[J]. Dermatology,2019,235(3):196-204.
[10] 向娟,王华,刘欢,等.特应性皮炎与血清脂溶性维生素水平的相关性分析[J].临床儿科杂志,2019,37(8):578-582.
[11] Kim Y,Blomberg M,Rifas-Shiman SL,et al. Racial/ethnic differences in incidence and persistence of childhood atopic dermatitis[J]. J Invest Dermatol,2019,139(4):827-834.
[12] 王静,张悦,谭美珍,等.脐血25-羟基维生素D水平与6月龄婴儿特应性皮炎的发生及严重程度的关系[J].中国儿童保健杂志,2019,27(10):1115-1119.
[13] 李梅云,谢丽,何欢,等.儿童特应性皮炎严重度与维生素D水平的相关性[J].临床儿科杂志,2019,37(10):727-730.
[14] 赵锐瑾,孙荣刚,孙秀珂,等.自制维生素E丙三醇悬浮液防护乳腺癌术后放射性皮肤损伤的研究[J].护理学杂志,2016,31(2):13-15.
[15] Jaffary F,Faghihi G,Mokhtarian A,et al. Effects of oral vitamin E on treatment of atopic dermatitis:A randomized controlled trial[J].J Res Med Sci,2015,20(11):1053-1057.