目的 分析口服补锌对轮状病毒性肠炎(RE)儿童血锌、免疫球蛋白、补体和炎症因子的变化,为临床有效治疗提供参考。方法 2015年10月-2016年10月收集82例RE患儿,随机分为补锌组42例,基础治疗组40例。基础治疗组给予常规治疗,补锌组在常规治疗的基础上加服葡萄糖酸锌20 mg/d,连续治疗14 d。两组患儿分别检测治疗前后空腹血锌、免疫球蛋白、补体和炎症因子水平,并与同期102例健康儿进行比较。结果 与对照组比,RE患儿血锌、免疫球蛋白G(IgG)、免疫球蛋白A(IgA)、免疫球蛋白M(IgM)、补体3(C3)、补体4(C4)和白细胞介素2(IL-2)水平明显降低(P<0.05),肿瘤坏死因子(TNF-α)和白细胞介素-8(IL-8)明显增高(P<0.05)。治疗后,RE患儿血锌、IgG、IgA、IgM、C3、C4和IL-2水平明显增高 (P<0.05),TNF-α和IL-8明显降低(P<0.05),与基础治疗组比,补锌组血锌、IgG、IgA、IgM、C3、C4和IL-2水平明显增高 (P<0.05),TNF-α和IL-8明显降低(P<0.05)。与基础治疗组比,补锌组的症状持续时间明显缩短(P<0.05)。两组在治疗过程中未出现明显的不良反应。结论 RE患儿缺乏微量元素锌,伴随IgG、IgA、IgM、C3、C4降低,促炎因子增高,抑炎因子降低。补充锌可提高RE患儿外周血IgG、IgA、IgM、C3、C4和IL-2,降低TNF-α和IL-8,缩短肠炎症状持续时间。

Objective To analyze the effect of zinc supplementation on the levels of zinc, immune globulin, complements and inflammatory cytokines of children with rotavirus enteritis(RE). Methods A total of 82 children with RE were randomly divided into the zinc supplementation group (42 cases) and RE group (40 cases) from October 2015 to October 2017.The routine treatment group was given conventional therapy and the zinc supplementation treatment group was treated with oral zinc gluconate tablets 20 mg/d for 14 days additionally.And 102 healthy children were collected as control group at the same time.The levels of zinc, immune globulin, complements and inflammatory cytokines among three groups were tested and compared after treatment. Results Compared with control group, the levels of zinc, immunoglobulin G(IgG), immunoglobulin A(IgA), immunoglobulin M(IgM), complement 3(C3), complement 4(C4) and interleukin-2(IL-2) were obviously lower in children with RE before treatment (P<0.05), while the levels of tumor necrosis factor alpha(TNF-α) and interleukin-8 (IL-8) increased in two RE groups(P<0.05).After treatment, the levels of zinc, IgG, IgA, IgM, C3, C4 and IL-2 had significantly increased (P<0.05), while the TNF-α and IL-8 decreased in two RE groups (P<0.05).Compared with the routine treatment group, the levels of zinc, IgG, IgA, IgM, C3, C4 and IL-2 increased after treatment(P<0.05),while the TNF-α and IL-8 decreased in the zinc supplementation group(P<0.05).Moreover, the duration of symptom in the zinc supplementation group was significantly lower than that in the routine treatment group (P<0.05).There were no obvious adverse reactions in two RE groups during treatment. Conclusion Zinc deficiency is prevalent in children with RE, with decreasing level of IgG, IgA, IgM, C3, C4 and increasing level of inflammatory factors.Zinc supplementation can increase serum levels of zinc, IgG, IgA, IgM, C3, C4 and IL-2, decrease serum TNF-α, IL-8 and the duration of symptoms.