血清锌水平与儿童特应性皮炎关系的初步探讨

Preliminary study on the relationship between serum zinc levels and atopic dermatitis in children

目的:探讨锌缺乏与儿童特应性皮炎(atopic dermatitis,AD)发病的关系。方法:收集该院皮肤科门诊2012年3月—2014年9月就诊的62例AD患儿,并随机分为补锌组和常规治疗组(常规组),健康对照组为50例体检的健康儿童。治疗前、后检测血清锌及IgE水平,应用湿疹面积和严重程度指数评分(EASI)、视觉模拟评分法(VAS)及欧洲特应性皮炎评分标准(SCORAD)对AD患儿病情进行评价。结果:治疗前AD患儿血清锌浓度显著低于健康对照组(P=0.015),但总IgE水平显著升高(P=0.023)。治疗后,补锌组患儿血清锌水平显著高于常规组;治疗8周后,补锌组及常规组血清总IgE水平分别为(62.78±13.79)k U/L和(119.68±15.89)k U/L,健康对照组为(56.82±24.65)k U/L,差异具有统计学意义(P<0.05)。治疗后4周及8周,补锌组与常规组EASI、VAS及SCORAD评分比较,差异有统计学意义(P<0.05);且补锌组治疗后8周与治疗前比较,差异亦有统计学意义(P<0.05)。结论:血清锌含量的降低可能是AD发病的重要原因之一,口服补锌可以改善AD的临床症状,是AD治疗的重要手段之一。

Objective： To explore the relationship between serum zinc levels and atopic dermatitis （AD） in children. Methods： From March 2012 to September 2014, 62 children with AD were randomly divided into two groups （zinc supplemental and non zinc supplemental group）. 50 healthy children served as normal controls. Eczema assessment severity index （EASI）, visual ana- logue scale （VAS）, scoring atopic dermatitis （SCORAD）, serum zinc and IgE levels were assessed before and after treatment. Results： In comparison with normal controls, the baseline zinc levels were significantly lower in AD patients （P=0.015）, while the total IgE levels were higher （P=0.023）. After zinc supplement, serum zinc levels in zinc supplemental group were higher than that in non zinc supplemental group. After 8 weeks of treatment, the total IgE levels differed significantly among three groups （62.78±13.79 kU/L in zinc supplemental group; 119.68±15.89kU/L in non supplemental group, and 56.82±24.65 kU/L in normal controls, P〈0.05 between groups）. After 4 weeks and 8 weeks of treatment, the differences of EASI, VAS and SCORAD were significant between zinc supplemental and non zinc supplemental group （P〈0.05）. Moreover, after 8 weeks of zinc supplement, EASI, VAS and SCORAD were markedly improved from baseline （P〈0.05）. Conclusions： Zinc deficiency may be a risk factor for AD. Oral zinc suoolement can imnrove the clinical svmotoms of AD. It is an notional regimen for AD.