目的 分析儿童反复呼吸道感染(RRTI)与患儿血清维生素A、D、E水平的相关性,为临床防治提供理论依据。方法 2017年1-12月采集在广西壮族自治区人民医院儿科就诊的6个月~15岁儿童资料,选取171例RRTI儿童为RRTI组,156例为正常对照组。采用高效液相色谱法测定两组儿童血清维生素A和E水平,采用化学发光法检测血清维生素D3水平。比较RRTI组和正常对照组维生素A、D3、E水平的差异。结果 RRTI组平均血清维生素A水平为(0.30±0.06)mg/L,维生素D3水平为(72.41±25.59)nmol/L,维生素E水平为(8.90±2.32)mg/L,均低于正常组的(0.39±0.07)mg/L、(84.84±29.96)nmol/L和(9.72±2.61)mg/L,差异均有统计学意义(P<0.01)。维生素A、D3缺乏率和不足率、维生素E的不足率在RRTI组均高于正常对照组,差异有统计学意义(P<0.05)。Logistic回归分析提示维生素A水平低(<0.3 mg/L)(OR=19.225,95%CI:9.136~40.453)和维生素D3缺乏(<50 nmol/L)(OR=2.891,95%CI:1.186~7.044)使得儿童患RRTI的风险增高。结论 维生素A和维生素D3的亚临床水平缺乏可能与儿童RRTI相关,及时给予补充有助于儿童RRTI的防治。
Abstract
Objective To investigate the association of serum levels of vitamin A, D and E with recurrent respiratory tract infections(RRTIs). Methods Children aged 6 months-15 years in People′s Hospital of Guangxi Zhuang Autonomous Region were enrolled to finish a face-to-face survey from January to December 2017. Totally 171 children with RRTIs were selected as the RRTI group, whereas 156 health children were used as control group. Blood samples were collected, and high performance liquid chromatography (HPLC) was used to measure serum levels of vitamin A and E. The serum level of 25(OH)D3 was tested by chemiluminescence. The differences on serum levels of vitamin A, D, E were analyzed between RRTI group and control group. Results The average levels of vitamin A[(0.30±0.06) mg/L vs.(0.39±0.07) mg/L], vitamin D3 [(72.41±25.59) nmol/L vs.(84.84±29.96) nmol/L] and vitamin E [(8.90±2.32) mg/L vs. (9.72±2.61)mg/L] in RRTI group were significantly lower than those in control group(P<0.01).The deficiency and insufficiency rate of vitamin A、D3, and vitamin E insufficiency rate in RRTI group were significantly higher than those in normal control group (P<0.05). Logistic regression analysis showed that vitamin A level lower than 0.3 mg/L (OR=19.225,95%CI: 9.136-40.453) and vitamin D3 level lower than 50 nmol/L(OR=2.891,95%CI:1.186-7.044) increased the risk of RRTIs in children. Conclusion The insufficiency of vitamin A and D3 may be critically associated with RRTIs of children.
关键词
呼吸道感染 /
维生素A /
维生素D /
维生素E /
儿童
Key words
respiratory infection /
vitamin A /
vitamin D /
vitamin E /
children
{{custom_sec.title}}
{{custom_sec.title}}
{{custom_sec.content}}
参考文献
[1] 中华医学会儿科学分会呼吸学组, 《中华儿科杂志》编辑委员会. 反复呼吸道感染的临床概念和处理原则[J].中华儿科杂志, 2008,46(2):108-110.
[2] 江载芳, 申昆玲, 沈颖. 诸福棠实用儿科学[M].8版.北京:人民卫生出版社, 2014:553-555.
[3] 全国佝偻病防治科研协作组,中国优生科学协会小儿营养专业委员会. 维生素缺乏及维生素D缺乏性佝偻病防治建议[J].中国儿童保健杂志,2015,23(7):781-782.
[4] Pilz S, Trummer C, Pandis M, et al. Vitamin D: current guidelines and future outlook[J].Anticancer Res, 2018,38(2):1145-1151.
[5] Zhang X, Ding F, Li H, et al. Low serum levels of vitamins A, D, E are associated with recurrent respiratory tract infections in children living in Northern China: a case control study[J].PLoS One,2016,11(12):e0167689.
[6] 李丽梅,李伟英. 5岁以下儿童维生素A亚临床缺乏与贫血和呼吸道感染的关系及预防措施[J]. 临床和实验医学杂志, 2014,13(22):1889-1891.
[7] Brown CC, Noelle RJ. Seeing through the dark: New insights into the immune regulatory functions of vitamin A[J]. Eur J Immunol, 2015,45(5):1287-1295.
[8] Trochoutsou AI, Kloukina V, Samitas K, et al.Vitamin-D in the immune system: genomic and non-genomic actions[J]. Mini Rev Med Chem, 2015,15(11):953-963.
[9] Shalaby SA, Handoka NM, Amin RE. Vitamin D deficiency is associated with urinary tract infection in children[J]. Arch Med Sci, 2018,14(1):115-121.
[10] Wang X, Liu L, Li P, et al. Reference and influential factors of serum bone markers in chinese adolescents[J]. Sci Rep, 2017,7(1):17340.
[11] 孙景春, 魏倩, 武月婷, 等. 高剂量维生素E对大鼠氧化应激状态和甲状腺功能的影响[J].吉林大学学报:医学版,2014,40(2):281-284.
基金
国家卫生计生委员会卫生科技发展研究中心课题(W2016EWQT15)