维生素A对毛细支气管炎患儿免疫状态及预后的影响

Effect and Significance of Vitamin A on Immune Function and Prognosis in Children with Bronchiolitis

目的:研究血清维生素A水平对毛细支气管炎患儿的免疫状态及预后的影响。方法:本研究纳入76例毛细支气管炎患儿为研究对象。随机分为观察组40例和对照组36例,两组患儿接受相同的常规治疗及护理措施,同时观察组口服维生素A制剂,对照组口服安慰剂,比较两组患儿急性期临床症状缓解时间及住院时间、出院6个月后随访情况及血清CD4^+、CD8^+、CD4^+/CD8^+、Ig E、Ig A及Ig G水平。结果:两组患儿急性期比较,观察组在咳嗽缓解时间、哮鸣音消失时间及住院时间较对照组缩短(P<0.05)。治疗后,两组患儿血清CD4^+、CD4^+/CD8^+、Ig A、Ig G水平升高,而血清CD8^+、Ig E水平降低(P<0.05);观察组血清Ig A、Ig G、CD4^+、CD4^+/CD8^+水平较对照组高(P<0.05),而血清CD8^+、Ig E水平较对照组低(P<0.05)。出院随访6个月,观察组患上呼吸道感染例数、再次喘息次数及再住院例数均较对照组少(P<0.05)。结论:血清维生素A水平与毛细支气管炎发生、发展及预后存在一定的相关性。补充外源性维生素A可以改善毛细支气管炎患儿急性期症状,缩短住院时间,并可影响患儿的免疫功能状态,改善远期预后。

Objective： To study the effect of serum vitamin A on immune function and prognosis in children with bronchiolitis.Methods： Seventy-six children with bronchiolitis were enrolled to be randomly divided into observation group（ n = 40） and control group（n= 36）. Two groups were given the same routine treatment and nursing measures,in the meantime,the observation received oral vitamin A preparations and the control group was treated with placebo. The relief time of clinical symptoms and length of stay in the acute phase,the follow-up after 6 months of discharge and the serum CD4~＋,CD8~＋,CD4~＋/CD8~＋,Ig E,Ig A,and Ig G levels of two groups were compared. Results： Compared with the control group,the relief time of cough,disappearance time of wheezing and length of stay in observation group were shorter than those in control group（ P0.05）. After treatment,the serum CD4~＋,CD4~＋/CD8~＋,Ig A,Ig G levels of two groups increased significantly,while the serum CD8~＋and Ig E levels decreased（ P0.05）. The serum Ig A,Ig G,CD4~＋and CD4~＋/CD8~＋levels in observation group were higher than those in control group（ P 0.05）,while the serum CD8~＋and Ig E levels were lower than those in control group（ P0.05）. After 6 months of follow-up,the number of cases of upper respiratory tract infection,the number of recurrent asthma and the number of hospitalizations in observation group were less than those in control group（ P0.05）. Conclusion：There is a certain correlation between serum vitamin A levels and the occurrence, development and prognosis of bronchiolitis.Supplementation of exogenous vitamin A can improve the acute phase symptoms of children with bronchiolitis,shorten the length of stay,affect the immune function of children and improve long-term prognosis.