血清维生素D水平与儿童反复呼吸道感染的关系

Relationship between Serum Vitamin D Level and Repeated Respiratory Infection in Children

目的检测反复呼吸道感染(RRI)患儿血清25-羟维生素D3[25-(OH)D3]及IgA水平,并行维生素D(VitD)治疗,探讨VitD营养状况与儿童RRI及免疫功能的关系,为临床治疗提供依据。方法选取2010年10月-2011年4月在本院儿科门诊就诊的RRI患儿60例为病例组。年龄1～6(3.91±2.83)岁;男32例,女28例。将病例组随机分为常规治疗组30例和补VitD组30例,均予抗感染及对症治疗,补VitD组另进行补VitD治疗。随机选取同期到门诊体检的健康儿童30例为健康对照组。受检儿童均晨起空腹抽取静脉血3 mL 2份,离心,分离血清。ELISA法检测其血清25-(OH)D3水平,免疫透射比浊法检测其血清IgA水平,进行组间比较。病例组3个月时复查血清25-(OH)D3及IgA水平。病例组儿童随访6个月,观察并记录呼吸道感染的复发次数。结果1.病例组血清25-(OH)D3及IgA水平显著低于健康对照组,2组比较差异均有统计学意义(Pa<0.01)。2.采用不同的方法治疗后补VitD组25-(OH)D3及IgA水平升高,常规治疗组和补VitD组RRI次数比较差异有统计学意义(P<0.01)。结论 RRI患儿血清25-(OH)D3及IgA水平低于健康儿童,低水平25-(OH)D3与RRI有关,提示对RRI患儿应重视VitD的补充。

Objective To explore the relationship between serum vitamin D3 （VitD） deficiency and repeated respiratory infection （RRI） by measuring the serum level of VitD3 and immunoglobulin A （IgA） in children with and without RRI and provide identifiable ground for cli- nical therapy. Methods From Oct. 2010 to Apr. 2011,60 outpatients with RRI, aged from 1 to 6 years old with mean age of （3.91 ± 2.83 ） years old, included 32 male and 28 female, were enrolled and randomly divided into 2 groups. Both groups underwent routine treatment, while the VitD group was treated with additional supplement of VitD. During the same period, another 30 healthy children were enrolled as control group. All samples were separated from venous blood of fasting patients （3 mL/sample and 2 samples/patient） ,and the level of serum 25 - hydroxy vitamin D3 was determined by ELISA and IgA was determined by immunological transmission turbidity. The measurement was repeated for patients with RRI at 3 months and the frequency of respiratory infection was recorded in the 6 - month follow - up. Results 1. The serum levels of 25 -hydroxy vitamin D3 and IgA were significantly lower in children with RRI （Pa 〈 0.01 ）. 2. For RRI children, recurrence of re- spiratory infection was statistically reduced （P 〈 0.01 ） in those received additional VitD. Conclusions The levels of 25 - hydroxy vitamin D3 and IgA are lower in RRI children than those in healthy children ; the deficiency of 25 - hydroxy vitamin D3 was responsible for the high re- currence of RRI and additional VitD3 supplement should be emphasized.