儿童非典型呼吸道病原体感染与维生素D水平的相关研究

Correlation between atypical respiratory pathogens infection and vitamin D level in children

目的探讨儿童非典型呼吸道病原体感染与维生素D(VitD)水平之间的关系。方法应用呼吸道十一联检测试剂盒(间接免疫荧光法)对414例儿童呼吸道感染患者的血清样本进行11项非典型呼吸道病原体的IgM抗体检测,包括呼吸道合胞病毒(RSV)、腺病毒(Adv)、流感病毒A型(FluA)、流感病毒B型(FluB)、副流感病毒(PFlu)、肺炎支原体(MP)、肺炎衣原体(CP)、柯萨奇病毒B型(CoxB)、柯萨奇病毒A型(CoxA)和嗜肺军团菌(LP)等;同时应用电化学发光法检测血清样本的VitD水平。结果 414份标本中共有214份检出病原体IgM(51.69%),检出率居前3位的依次为FluB、FluA及MP,阳性检出率分别为32.13%、23.19%、13.77%。在IgM抗体阳性病例中,17.63%的患儿发生单一感染,34.06%的患儿为混合感染。IgM抗体阳性组的VitD水平(中位数23.60ng/mL,3.37~71.50ng/mL)与阴性组(中位数23.95ng/mL,3.00~81.70ng/mL)之间差异无统计学意义(P>0.05)。VitD偏低组与VitD正常组之间总感染阳性率、单一感染阳性率和混合感染阳性率差异均无统计学意义(P>0.05),VitD偏低组与VitD正常组之间FluB、FluA及MP IgM抗体阳性率差异均无统计学意义(P>0.05)。非典型呼吸道病原体与VitD之间无相关性(r=0.005,P=0.912)。结论非典型呼吸道病原体感染可能与VitD水平降低无关。

Objective To investigate the correlation between atypical respiratory pathogens infection and serum vitamin D （VitD） level in children. Methods Serum IgM antibody levels of 11 atypical respiratory pathogens were detected in 414 serum sam- ples of child respiratory infection by using the respiratory tract ll-items detection reagent kits （indirect immunofluorescence as- say） ,including respiratory syncytial virus（RSV）, adenovirus（ADV）, influenza A virus （FluA）, influenza B virus （FluB）, parainflu- enzavirus （PFlu）, Mycoplasma pneumonia（MP）, Chlalmydia pneumoniae（CP）, Coxsackie virus type B （CoxB）, Coxsackie virus type A（CoxA） and legionella pneumophilia（LP）. At the same time the electrochemiluminescence assay was used to measure serum VitD level. Results Among 414 samples, pathogen IgM was detected out in 214 samples （51.69%）, the top three places of detection rates were FluB, FluA and Mp, their positive rates were 32.13 %,23.19 % and 13.77 % respectively;in cases of positive IgM anti- body, 17.63 ~ of children developed single infection, 34.06% of children developed 2 kinds of pathogen or more mixed infection; there was no statistical difference in the VitD levels between the IgM antibody positive group （median 23.60 ng/mL, 3.37-71.50 ng/mL） and the IgM antibody negtive group（median 23.95 ng/mL, 3.00--81.70 ng/mL）. The IgM antibody positive rate, single infection positive rate and mixed infection positive rate had no statistical difference between the VitD reduce group and the VitD normal group（P〉0.05）. The positive rate of FluB,FluA and MP IgM antibody had no statistical difference between the VitD re- duce group and the VitD normal group（P〉0.05）. Atypical respiratory pathogens had no correlation with VitD（r= 0. 005, P = 0. 912）. Conclusion Atypical respiratory pathogens infection may had no correlation with the VitD level reduce.