儿童边缘型维生素A缺乏与呼吸道感染相关性及危险因素分析

Relationship between marginal vitamin A deficiency and respiratory tract infections in children and its risk factors

目的分析儿童边缘型维生素A缺乏（VAD）与呼吸道感染的关系及其危险因素,为能有效防治提供参考依据。方法选取2015年4-10月门诊儿童160例,分为反复呼吸道感染现症感染组（A组）42人、反复呼吸道感染无现症感染组（B组）24人、急性呼吸道感染组（C组）18人、健康查体组（D组）76人。采用高效液相色谱法（HPLC）检测其血清维生素A水平,以血清VA水平介于0.20~0.30mg/L为边缘型VA缺乏（MVAD）的诊断标准。结果 1）A、B、C组的血清VA值分别为（0.27±0.07）mg/L、（0.28±0.04）mg/L和（0.28±0.09）mg/L,均明显低于D组（0.33±0.08）mg/L（P〈0.05）。2）反复呼吸道感染患儿MVAD检出率显著高于非反复呼吸道感染组,差异具有统计学意义（P〈0.05）。3）Logistic回归分析显示：儿童边缘型维生素A缺乏的危险因素有家居农村、食欲欠佳、现患呼吸道感染。结论维生素A缺乏可能是导致儿童反复呼吸道感染的重要原因之一,呼吸道感染可加重体内维生素A的缺乏;家居农村、食欲欠佳、现患呼吸道感染与儿童边缘型维生素A缺乏关系密切。

Objective To explore the relationship between marginal vitamin A deficiency and respiratory tract infections in children and its risk factors. Methods One hundred and sixty children between April 2015 and October 2015 were enrolled in the study,including 42 cases of RRI in acute infection（A group）,24 cases of repeated respiratory infection（RRI）in non-acute infection（B group）,18 cases of acute respiratory tract infection（C group）and 76 health children（D group）.The serum vitamin A level was measured by high performance liquid chromatography（HPLC）.Serum VA level ranged from 0.20 to 0.30mg/L was considered as marginal vitamin A deficiency（MVAD）. Results 1）The serum VA levels of A group[（0.27±0.07）mg/L],B group[（0.28±0.04）mg/L]and C group[（0.28±0.09）mg/L]were lower than those of D group[（0.33±0.08）mg/L]（P〈0.05）.2）The incidence of MVAD in RRI children was significantly higher than that in non-RRI children（P〈0.05）.3）Logistic regression analysis showed that living in rural area,poor appetite and having acute respiratory infection all were risk factors for MVAD. Conclusions Vitamin A deficiency may be one of the important reasons of RRI in children,and acute infection can aggravate the lack of VA in vivo.Children who were living in rural area,with poor appetite or having acute respiratory infection,were more susceptible for MVAD.