25-羟维生素 D3水平与婴幼儿社区获得性肺炎的关系

Relationship between serum 25-hydroxy vitamin D3 concentration and community-acquired pneumonia in infants

目的：探讨血清25-羟维生素 D3[25-（OH）D3]水平与婴幼儿社区获得性肺炎（CAP）的关系及临床意义。方法选取98例社区获得性肺炎患儿，其中普通肺炎组68例，重症肺炎30例，分别测定其血清中25-（OH）D3、IgA 和碱性磷酸酶（AKP）水平，选择同期在该院门诊健康体检的33例健康婴幼儿作为对照组。结果重症肺炎组、普通肺炎组、对照组血清25-（OH）D3水平分别为（21．09±7．32）ng／mL、（25．77±8．06）ng／mL、（37．13±6．94）ng／mL，各组间差异有统计学意义（t ＝9．18、3．72、5．34，均 P ＜0．05）；重症肺炎组、普通肺炎组、对照组血清 IgA 水平较各组间差异有统计学意义（t ＝5．42、3．96、8．92，均 P ＜0．05）。AKP水平各组间差异无统计学意义（t ＝0．86、0．58、0．47，均 P ＞0．05）。重症肺炎组维生素 D 缺乏率为40．0％，显著高于普通肺炎组的20．6％及对照组的9．1％（χ^2＝8．43、17．55，均 P ＜0．05）。结论CAP 患儿血清25-（OH）D3、IgA 水平低于健康儿童，在重症肺炎患儿中更明显；重症肺炎患儿维生素 D 缺乏率显著高于健康儿童。25-（OH）D3与 IgA、AKP 的检测无明显相关性。因此，维生素 D 在 CAP 的发生及发展中具有重要作用，婴幼儿低水平血清25（OH）D3可能是 CAP 发生的风险因素之一，而且与病情严重程度相关。

Objective To investigate the relationship and clinical significance between the concentration of 25-hydroxy vitamin D3 [25-（OH）D3 ]in the serum and community-acquired pneumonia（CAP）in infants.Methods The study recruited 98 infants.There were 68 cases of mild pneumonia and 30 cases of severe pneumonia.The con-centration of 25-（OH）D3 in serum,IgA and alkaline phosphatase（AKP）were measured.33 infants who accepted physical examination in the outpatient department were selected as control group at the same time.Results The serum 25-（OH）D3 concentration of severe pneumonia was （21.09 ±7.32）ng/mL,mild pneumonia was （25.77 ± 8.06）ng/mL and the control group was （37.13 ±6.94）ng/mL.The differences among the three groups had statisti-cally significant differences（t =9.18,3.72,5.34,all P 〈0.05）.The differences of serum IgA concentration among the three groups had statistically significant differences （t =5.42,3.96,8.92,all P 〈0.05）.But serum AKP concen-tration among the three groups had no statistically significant differences（t =0.86,0.58,0.47,all P 〉0.05）.The prevalence of Vitamin D deficiency was 40.0%,which was higher than mild pneumonia patients（20.6%）and the healthy children（9.1%）（χ^2 =8.43,17.55,all P 〈0.05）.Conclusion The serum 25-（OH）D3 concentration and IgA of CAP patients were lower than healthy children,especially in severe pneumonia cases.The prevalence of Vita-min D deficiency was significantly higher than healthy children.There were no relevance between the serum concentra-tion of 25-（OH）D3 ,IgA and AKP.25-（OH）D3 plays an important role in the development of CAP.The low level of serum 25-（OH）D3 concentration may be one of the risk factors and has correlation to the severity of pneumonia.