目的 探讨维生素A对婴幼儿反复呼吸道感染免疫调节作用,为临床治疗提供参考依据。方法 选取2015年1月-2016年1月期间诊治353 例半岁~3 周岁的反复呼吸道感染婴幼儿,随机分为治疗组(176 例)和对照组(177例)。两组婴幼儿均给予抗感染及对症等常规治疗,治疗组婴幼儿在此基础上加用口服维生素A (2.0万U / d),随访3个月,治疗前后检测T细胞亚群和免疫球蛋白,并进行两组临床疗效评判,随访期间统计患者呼吸道感染复发次数。结果 治疗组治疗后T免疫球蛋白(IgG、IgA、IgM)、细胞亚群(CD₃、CD₄、CD₄/CD₈)均较治疗前显著升高,差异具有统计学意义(P<0.05);对照组治疗前后免疫球蛋白及T细胞亚群差异无统计学意义;治疗后的组间结果比较,治疗组免疫球蛋白(IgG、IgA、IgM)均高于对照组(P<0.05),特别是T细胞亚群(CD₃、CD₄、CD₄/CD₈)差异具有高度统计学意义(P<0.01)。3个月期间,比较两组间平均呼吸道感染次数,结果显示治疗组的患病次数显著少于对照组(P<0.05)。结论 维生素A 具有提高反复呼吸道感染婴幼儿机体免疫力,并降低其疾病的复发次数和缩短病程的作用,值得临床推广使用。

Objective To investigate the effect of vitamin A on immune regulation in children with recurrent respiratory tract infection(RRTI),and to provide reference for clinical treatment. Methods Infants of 0.5~3 years old from January 2015 to January 2016,353 cases of RRTI in were divided into treatment group (176 cases) and control group (177 cases).Two groups were given routine treatment of anti infection and symptomatic treatment,treatment group based on the use of oral vitamin A (20 thousand U/D),after 3 months of follow-up,T cell subsets and immunoglobulin were detected before and after treatment,and two groups of clinical curative effect evaluation,recurrence times during follow-up of patients with RRTI. Results T immune globulin treatment group (IgG,IgA,IgM),cell subsets (CD₃,CD₄,CD₄/CD₈) were significantly higher than that before treatment,the difference was statistically significant (P<0.05);The control group before and after treatment with immunoglobulin and T cell subsets had no significant difference;Treatment after the comparison of the results between groups,the treatment group of immunoglobulin (IgG,IgA,IgM) were higher than the control group (P<0.05),especially T cell subsets (CD₃,CD₄,CD₄/CD₈) with significant statistical differences.During the period of 3 months,the average number of respiratory infections among the two groups was compared.The results showed that the treatment group was significantly less than the control group (P<0.05). Conclusion Vitamin A can improve the immunity of infants and young children with RRTI,and reduce the frequency of recurrence of the disease and shorten the course of disease,it is worthy of clinical application.