维生素D对反复呼吸道感染儿童的免疫调节作用

Immunomodulatory Effects of Vitamin D on Children with Recurrent Respiratory Tract Infections

目的:观察维生素D治疗儿童反复呼吸道感染(RRI)的临床疗效及其对患儿血清25-羟维生素D3[25-(OH)D3]和免疫球蛋白(IgA、IgM、IgG)水平的影响。方法:选取2010年7月至2012年6月在我院儿科就诊的RRI患儿66例,采用随机数字表法分为治疗组和观察组各33例,两组均给予常规治疗,治疗组给予口服阿法骨化醇胶囊,每次0.25μg,每周3次,连续服用3个月,RRI患儿随访1年,观察并记录呼吸道感染的复发次数。另选取同期健康体检的儿童30例为对照组,比较三组血清25-(OH)D3、IgA、IgM、IgG水平。结果:治疗组和观察组总有效率分别为93.3%和73.3%,差异有统计学意义(P<0.05);治疗后治疗组患儿呼吸道感染次数明显减少,与观察组比较差异有统计学意义(P<0.01);补充维生素D后治疗组血清25-(OH)D3和IgA、IgM、IgG水平明显升高(P<0.01),观察组各项指标改变不明显(P>0.05),两组比较差异有统计学意义(P<0.01)。结论:RRI患儿存在血清25-(OH)D3低水平和体液免疫功能降低,适当地补充维生素D能调节机体免疫功能,减少呼吸道感染发生率和严重程度。

Objective： To observe the clinical efficacy of vitamin D in treatment of children with recurrent respiratory infections （RRI）, and the effects on serum levels of 25-（OH） D3 and immunoglobulin （IgA, IgM, IgG）. Methods： From July 2010 to June 2012, 66 cases of children with RRI in pediatrics department of our hospital were randomly divided into a treatment group and an observation group equally. Both groups were given routine treatment, while the treatment group received was given oral vitamin D-Alfacalcidol capsules,0.25 μg one time, 3 times a week for 3 months. RRI children were followed up for one year to observe and record the recurrence times of respiratory tract infection. During the same period, 30 healthy children were enrolled as a control group. Three groups＇ serum 25-（OH） D3 , IgA, IgM and IgG levels were compared. Results： ① The total efficiency of the treatment group and the observation group were 93.3% and 73.3%, and the difference was statistically significant （ P〈0.05 ） ; ② After treatment, the frequency of respiratory infection of the treatment group reduced significantly; there was a significant difference compared with the observation group （P〈0.01） ; ③Serum 25-（OH）D3, IgA, IgM and IgG levels of the treatment group increased significantly after complement Vit D treatment （P〈0.01）, while each index levels of the observation group did not change significantly （P〉0.05） ; the difference between the two groups was statistically significant （P〈0.01）. Conclusions： RRI children have 25-（OH） D3 level reduced and humoral immune function. Complement Vit D treatment can regulate body immunity, and reduce incidence and severity of respiratory tract infection.