川崎病患儿血清中25-羟基维生素D水平的变化及临床意义

Changes and clinical significance of serum 25-hydroxyvitamin D levels in children with Kawasaki disease

目的探讨川崎病(KD)患儿血清中25-羟基维生素D[25-(OH)D]水平的变化及临床意义。方法回顾性分析2009年9月～2017年9月我院收治的147例1～3岁KD患儿的临床资料,根据有无冠状动脉损伤(CAL),将其分为CAL组(76例)和非CAL组(NCAL,71例)。以静脉用丙种球蛋白(IVIG)疗效为标准,将其分为丙球敏感性KD组(117例)与丙球无反应KD组(30例)。另选取同期该年龄段健康儿童58例作为对照组,通过酶联免疫法检测各组的血清25-(OH)D水平。结果 CAL组的血清25-(OH)D水平为(33.24±7.74)nmol/L,低于NCAL组的(38.72±10.82)nmol/L和对照组的(43.00±13.10)nmol/L,差异有统计学意义(P<0.05);NCAL组的血清25-(OH)D水平低于对照组,差异有统计学意义(P<0.05)。丙球无反应KD组的血清25-(OH)D水平为(32.60±6.41)nmol/L,低于丙球敏感性KD组的(36.79±10.31)nmol/L和对照组的(43.00±13.10)nmol/L,差异有统计学意义(P<0.05);丙球敏感性KD组的血清25-(OH)D水平低于对照组,差异有统计学意义(P<0.05)。结论 KD患儿的血清25-(OH)D水平偏低,尤其出现CAL及丙球无反应时更低。

Objective To investigate the changes and clinical significance of serum 25-hydroxyvitamin D(25-[OH]D)levels in children with Kawasaki disease(KD).Methods The clinical data of 147 children aged 1-3 years old with KD hospitalized in our hospital from September 2009 to September 2017 were retrospectively analyzed.According to whether coronary artery lesion(CAL)occured,they were divided into the CAL group(76 cases)and the non-CAL group(NCAL,71 cases).According to the efficacy of intravenous immunglobulin(IVIG),they were divided into the immunglobulin sensitive KD group(117 cases)and the immunglobulin unresponsive KD group(30 cases).Another 58 healthy children of this age during the same period were selected as the control group.Serum 25-(OH)D levels were measured by enzyme-linked immunosorbent assay among the groups.Results The level of serum 25-(OH)D in the CAL group was(33.24±7.74)nmol/L,which was lower than that in the NCAL group accounting for(38.72±10.82)nmol/L and the control group accounting for(43.00±13.10)nmol/L,and the differences were statistically significant(P<0.05).The level of serum 25-(OH)D in the NCAL group was lower than that in the control group,and the difference was statistically significant(P<0.05).The level of serum 25-(OH)D in the immunglobulin unresponsive KD group was(32.60±6.41)nmol/L,which was lower than that in the immunglobulin sensitive KD group accounting for(36.79±10.31)nmol/L and the control group accounting for(43.00±13.10)nmol/L,and the differences were statistically significant(P<0.05).The level of serum 25-(OH)D in the immunglobulin sensitive KD group was lower than that in the control group,and the difference was statistically significant(P<0.05).Conclusions The level of serum 25-(OH)D is low in children with KD,and it is much lower especially in the incidence of CAL and under the immunglobulin unresponsive condition.