目的 分析新生儿社区获得性肺炎患儿血清25羟维生素D水平及淋巴细胞亚群变化,为临床治疗提供科学依据。方法 随机选取2018年11月-2019年1月在永康市第一人民医院诊断为社区获得性肺炎的68例足月新生儿为观察组,同期在本院产科出生的68例健康足月新生儿为对照组。采用BIO-RAD 680酶标仪ELISA法检测血清25羟维生素D水平及采用BD公司Facs Canto2流式细胞仪检测淋巴细胞亚群。结果 观察组与对照组比较,观察组血清25羟维生素D水平明显低于对照组,差异有统计学意义(t=6.815,P＜0.01)。观察组CD3+ 和CD4+细胞阳性率以及CD4+/CD8+比值,均显著低于照组(t=2.912、2.947、3.115,P＜0.01);观察组CD19+细胞阳性率显著高于对照组(t=5.565,P＜0.01)。观察组中25羟维生素D 缺乏组与正常组比较,缺乏组CD3+和CD4+细胞阳性率以及CD4+/CD8+,均显著低于正常组(t=3.084、4.234、3.021,P＜0.01);而缺乏组CD19+细胞阳性率显著高于正常组(t=3.515,P＜0.01)。结论 社区获得性肺炎新生儿的25羟维生素D缺乏发生率较高;社区获得性肺炎新生儿细胞免疫水平偏低,可能与25维生素D水平低有关。
Abstract
Objective To analysis the serum 25-hydroxyvitamin D level and lymphocyte subsets in neonates with community acquired pneumonia,and to provide evidence for clinical treament. Methods A total of 68 full-term neonates diagnosed with community acquired pneumonia in the First People′s Hospital of Yongkang City from November 2018 to January 2019 were randomly selected as the observation group,and 68 healthy full-term neonates born in the same period of our hospital as the control group.Serum 25-hydroxyvitamin D level was detected by BIO-RAD 680 ELISA and lymphocyte subsets were detected by Facs Canto2 flow cytometry of BD company. Results Compared with the control group,the serum 25-hydroxyvitamin D level in the observation group was significantly lower than that in the control group (t=6.815,P＜0.01).The positive rate of CD3+ and CD4+ cells and the ratio of CD4+/CD8+ in the observation group were significantly lower than those in the control group (t=2.912,2.947,3.115,P＜0.01); the positive rate of CD19+ cells in the observation group was significantly higher than that in the control group (t=5.565, P＜0.01).The positive rates of CD3+ and CD4 + cells,CD4+/CD8+ in the 25-hydroxyvitamin D deficiency group were significantly lower than those in the normal group (t=3.084,4.234,3.021,P＜0.01); but the positive rates of CD19+ cells in the deficient group was significantly higher than that in the normal group (t=3.515, P＜0.01). Conclusionss The incidence of 25-hydroxyvitamin D deficiency in neonates with community-acquired pneumonia is higher.The level of cellular immunity in neonates with community-acquired pneumonia is lower,which may be related to the low level of 25-vitamin D.
关键词
社区获得性肺炎 /
25羟维生素D /
淋巴细胞亚群 /
细胞免疫 /
新生儿
Key words
community acquired pneumonia /
25-hydroxyvitamin D /
lymphocyte subsets /
xellular immunity /
neonates
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参考文献
[1] 陈鸿羽,邓春.新生儿社区和院内获得性肺炎的病原学特点及药敏分析[J].临床儿科杂志, 2016,34(7):510-514.
[2] Hua W,Jun T,Ying X,et al.Neonatal community-acquired pneumonia:pathogens and treatment[J].J Paediatr Child Health,2010,46(11):668-672.
[3] 中华医学会儿科学分会儿童保健学组.儿童微量营养素缺乏防治建议[J].中华儿科杂志,2010,48(7):502-509.
[4] 温慧敏,闫向真,刘新建,等.新生儿社区获得性肺炎感染病原菌分布及其耐药性分析[J].实用预防医学,2015,22(1):108-109.
[5] Cetinkaya M,Cekmez F,Buyukkale G,et al.Lower vitamin D levels are associated with increased risk of early-onset neonatal sepsis in term infants[J].J Perinatol,2015,35(1):39.
[6] Mulrennan S,Knuiman M,Walsh JP,et al.Vitamin D and respiratory health in the Busselton Healthy Ageing Study[J].Respirology,2018,20(Suppl 60):49.
[7] Martineau AR,Jolliffe DA,Hooper RL,et al.Vitamin D supplementation to prevent acute respiratory tract infections:systematic review and meta-analysis of individual participant data[J].BMJ,2017,356.doi:10.1136/bmj.16583.
[8] Jovanovich AJ,Ginde AA,John H,et al.Vitamin D level and risk of community-acquired pneumonia and sepsis[J].Nutrients,2014,6(6):2196-2205.
[9] Larkin A,Lassetter J.Vitamin D deficiency and acute lower respiratory infections in children younger than 5 years:identification and treatment[J].J Child Health Care,2014,28(6):572-582.
[10] Sakka ASE,Imam SS,Amer HA,et al.Vitamin D deficiency and low hemoglobin level as risk factors for severity of acute lower respiratory tract infections in Egyptian children:A case-control study[J].Gaz Egypt Paediatr Assoc,2014,62(1):1-7.
[11] Rich RR,Fleisher TA,Shearer WT,et al.Clinical immunology:principles and practice[M].5th.Oxford:Elsevier Limited,2019:183-196.
[12] Vasiliou JE,Lui S,Walker SA,et al.Vitamin D deficiency induces Th2 skewing and eosinophilia in neonatal allergic airways disease[J].Allergy,2014,69(10):1380-1389.
[13] Goldsmith J.Vitamin D as an immunomodulator:Risks with deficiencies and benefits of supplementation[J].Healthcare,2015,3(2):219-232.
[14] Hornsby E,Pfeffer PE,Laranjo N,et al.Vitamin D supplementation during pregnancy:Effect on the neonatal immune system in a randomized controlled trial[J].J Allergy Clin Immunol,2018,141(1):269-278.
[15] K1l1caslan AÖ,Kutlu R,Kilinc I,et al.The effects of vitamin D supplementation during pregnancy and maternal vitamin D levels on neonatal citamin D levels and birth parameters[J].J Matern Fetal Neonatal Med,2017,31(13):1727-1734.
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