特应性皮炎患儿56例外周血25羟基维生素D的检测

Detection of 25 Hydroxy Vitamin D in Peripheral Blood of 56 Children with Atopic Dermatitis

目的观察特应性皮炎(atopic dermatitis,AD)患儿血清25-羟维生素D[25-(OH)Vit D]水平,探讨维生素D水平与儿童AD发病之间的关系以及AD严重程度与维生素D的关系。方法收集56例AD患儿(AD组),采用AD评分(SCORAD)对严重程度进行评分,抽取清晨空腹静脉血,检测血清25-(OH)Vit D水平,同时收集70例健康儿童(对照组)的清晨空腹血清25-(OH)Vit D水平。分别对男和女AD患儿、重度和中度、AD患者和健康对照组以及中度AD患者和健康对照组进行对比研究。结果AD组血清25-(OH)Vit D水平(51.32±18.56)nmol/L显著低于对照组(63.45±18.92)nmol/L(P<0.01)。AD组中33例(58.92%)血清25-(OH)Vit D水平低于正常值下限50nmol/L,对照组为14.28%(10/70),两组血清不同浓度25-(OH)Vit D的分布差异有统计学意义(P<0.01)。AD评分(SCORAD评分≥40分)的重度AD患儿血清25-(OH)Vit D水平低于(15分≤SCORAD评分<40分)中度AD患儿[(44.26±16.93)nmol/L vs.(57.43±17.96)nmol/L,P<0.01],男女AD患儿之间没有差异,中度与对照组无差异。结论 AD患儿25-(OH)Vit D水平明显低于健康儿童,而中度AD患儿与健康儿童无差异,推测AD病情加重可能与维生素D水平低下有关。

Objective To measure serum levels of 25-hydroxy vitamin D [ 25-（OH） VitD ] in children with atopic dermatitis（ AD）, and to investigate the effect of vitamin D on the development of AD and the severity. Methods Fifty-six AD children and 70 non-allergic controls were enrolled in this study. Disease severity was determined using the AD score （SCORAD）. Morning fasting venous blood samples were collected from AD children （group AD） and healthy children （control group） to measure serum 25-（OH） VitD levels. Serum 25- （OH） VitD levels were compared between male and female AD, severe and moderate AD, AD patients and healthy controls, moderate AD children and healthy controls, respectively. Results Serum levels of 25- （OH） VitD were lower in AD than in control group [ （51.32 ± 18.56） nmol/L vs. （63.45 ± 18. 92 ） nmol/L, P 〈0. 01 ]. In 58.92% （33/56） of AD and 14. 28% （10/70） of controls, the serum 25-（OH）VitD levels were below the normal levels of 50nmol/L although the 25-（OH） VitD levels were significantly different between AD and controls（ P 〈 0.01 ）. Serum 25-（OH） VitD levels in severe AD children（ SCORAD ≥40） were significantly lower than that in moderate AD children （ 15 ≤ SCORAD 〈 40） [ （ 44. 26 ± 16. 93 ） nmol/L vs. （57.43± 17. 96） nmol/L, P 〈 0. 01 ]. There was no difference in serum 25- （OH） VitD levels between male and female AD patients. Conclusion Serum 25- VitD （OH） levels in AD children were significantly lower than that in healthy children, while there were no differences between moderate AD and healthy children. It was speculated that the AD worsening may be related to the low level of vitamin D.