维生素A作为免疫佐剂用于提高儿童免疫功能的临床研究

Clinical investigation on application of vitamin A as an immune adjuvant in improving immune function of children

目的：研究反复呼吸道感染患儿血清Vit A含量与免疫功能变化,探讨Vit A作为免疫佐剂用于增强儿童免疫功能的可行性。方法：①收集反复呼吸道感染儿童（实验组）60例,并设对照组20例,年龄均为6个月-3岁。将实验组随机分为A、B两组,A组按常规剂量补充Vit A,B组为对照观察组。②采用微量荧光法检测实验组及对照组Vit A含量,应用流式细胞仪和免疫透射比浊法分别检测血淋巴细胞亚型CD3＋、CD3＋CD4＋、CD3＋CD8＋、CD4＋/CD8＋和免疫球蛋白IgG、IgA、IgM及C3。结果：实验组Vit A含量明显低于对照组（P〈0.05）,淋巴细胞亚型除CD8＋、免疫球蛋白除IgM外均较对照组明显降低;补充Vit A组Vit A含量较未补充组明显上升,血免疫指标除CD3＋CD8＋上升不明显外,余均明显高于非补充组;对实验组各项免疫指标进行相关分析,血清Vit A含量与CD3＋、CD3＋CD4＋、CD4＋/CD8＋、Ig A呈正相关,与CD3＋CD8＋呈负相关,与IgG、IgM和C3相关不明显。结论：反复呼吸道感染患儿体内Vit A含量及免疫功能均明显降低,对其补充Vit A后体内免疫指标随Vit A含量上升而升高。Vit A可作为免疫佐剂用于增强儿童免疫功能,其用量按Vit A缺乏症常规治疗剂量补充即可。

Objective：To study the serum level of vitamin A and changes of immune function in children with recurrent respiratory tract infection,explore the feasibility of vitamin A as an immune adjuvant in improving immune function of children.Methods：60 children with recurrent respiratory tract infection were selected as experimental group,20 children were selected as control group,their ages were from 6 months to 3 years;the children in experimental group were divided into A group and B group randomly,the children in A group were treated with conventional dose vitamin A,while B group was control observation group;the serum levels of vitamin A in experimental group and control group were detected by micro-fluorescence method;the blood lymphocyte subtypes（CD3＋,CD3＋CD4＋,CD3＋CD8＋,CD4＋/CD8＋）,immunoglobulins（IgG,IgA,IgM） and C3 were detected by flow cytometry and immune transmission turbidimetric method.Results：The serum level of vitamin A in experimental group was significantly lower than that in control group（P〈0.05）,and the amounts of blood lymphocyte subtypes（except CD8＋） and immunoglobulins（except IgM） in experimental group were significantly lower than those in control group;the serum level of vitamin A in vitamin A supplement group was significantly higher than that in non-vitamin A supplement group,the amounts of blood lymphocyte subtypes（except CD3＋CD8＋） in vitamin A supplement group were significantly higher than those in non-vitamin A supplement group;there was positive correlation between serum level of vitamin A and CD3＋,CD3＋CD4＋,CD4＋/CD8＋,IgA,there was negative correlation between serum level of vitamin A and CD3＋CD8＋,but there was no correlation between serum level of vitamin A and IgG,IgM,C3.Conclusion：The serum level of vitamin A and immune function decrease significantly in children with recurrent respiratory tract infection,after supplement of vitamin A,the indexes of immune function increase with the increase of serum vitamin A level;vitamin A can be used as an immune adjuvant in improving immune function of children,vitamin A should be supplied according to conventional dose of vitamin A deficiency.