社区获得性肺炎患儿25-羟维生素D水平与临床指标的相关性

Correlation between Serum 25-Hydroxy-Vitamin D Levels and Clinical Indicators in Children with Community-Acquired Pneumonia

目的:检测社区获得性肺炎(CAP)患儿的血清25-羟维生素D[25(OH)D]水平,探讨其与临床指标的相关性。方法:经儿童家长知情同意,选取2016年3月至2017年3月在我院确诊CAP的患儿110例作为研究组,同期在我院体检的110例正常儿童作为对照组,年龄纳入范围1个月～2岁,采用电化学发光法检测血清25(OH)D水平,分析其与CAP患儿一般资料、病程、病情、ALT、白蛋白、CK-MB、血钙、免疫球蛋白、血常规等指标的相关性。结果:CAP患儿血清25(OH)D水平为(28.21±1.43)ng/mL,其中维生素D缺乏或者不足的患儿比例为65.45%,高于对照组的18.18%(P<0.05)。日照充足季节(春夏秋)CAP患儿的血清25(OH)D水平为(39.00±22.72)ng/mL,高于日照不足季节(冬)的(16.00±8.37)ng/mL;≤1岁的患儿血清25(OH)D水平为(15.00±8.26)ng/mL,低于>1～2岁患儿的(37.00±11.45)ng/mL;病程>7 d的患儿血清25(OH)D水平为(18.00±0.27)ng/mL,低于病程≤7 d患儿的(26.00±3.21)ng/mL;重症患儿血清25(OH)D水平为(13.00±6.23)ng/mL,低于轻症患儿的(27.00±7.36)ng/mL;住院时间>7 d的患儿血清25(OH)D水平为(9.00±2.26)ng/mL,低于住院时间≤7 d患儿的(23.00±2.43)ng/mL(P均<0.05)。CAP患儿的血清25(OH)D水平与血钙、IgG、IgA水平呈正相关,与WBC、CRP水平呈负相关(P均<0.01);与PLT、RBC、血红蛋白、ALT、BUN、CK-MB水平无相关性(P均>0.05)。结论:CAP患儿25(OH)D缺乏或者不足较常见,其水平受年龄、病程、病情、住院时间、季节(日照时间)等因素的影响,与血钙、IgG、IgA、WBC、CRP水平有一定相关性。

Objective: To explore the correlation between serum 25-hydroxy-vitamin D (25(OH)D) levels and clinical indicators in children with community-acquired pneumonia (CAP). Methods: With the informed consent of the parents of children, 110 cases of children diagnosed with CAP in our hospital from Mar. 2016 to Mar. 2017 were selected as the study group, and 110 cases of normal children who underwent physical examination in our hospital during the same period were selected as the control group. All children were enrolled in the range of 1 month to 2 years old. The serum 25(OH)D levels were detected by electrochemiluminescence method. The correlation between 25(OH)D levels and general data, disease duration, disease conditions, ALT, albumin, CK-MB, blood calcium, immunoglobulin and blood routine was analyzed. Results: The serum 25(OH)D level of children with CAP was (28.21±1.43) ng/mL, and the proportion of children with vitamin D deficiency or insufficiency was 65.45%, which was higher than 18.18% of the control group (P<0.05). The serum 25(OH)D level of children with CAP was (39.00±22.72) ng/mL in the sunshine season (spring, summer and autumn), which was higher than (16.00±8.37) ng/mL in the sunshine shortage season (winter). The serum 25(OH)D level of children ≤ 1 year old was (15.00±8.26) ng/mL, which was lower than that of children >1 to 2 years old (37.00±11.45) ng/mL. The serum 25(OH)D level was (18.00±0.27) ng/mL in children with the disease duration >7 d, which was lower than (26.00±3.21) ng/mL in children with the disease duration ≤ 7 d. The serum 25 (OH) D level in severe children was (13.00±6.23) ng/mL, lower than (27.00±7.36) ng/mL in mild children. The serum 25(OH)D level was (9.00±2.26) ng/mL in children with length of stay >7 d, which was lower than (23.00±2.43) ng/mL in children with length of stay ≤7 d (P<0.05). The serum 25(OH)D levels in children with CAP were positively correlated with serum calcium, IgG, and IgA levels, and negatively correlated with WBC and CRP levels (P<0.01);and there was no correlation with PLT, RBC, hemoglobin, ALT, BUN and CK-MB levels (P>0.05). Conclusion: Serum 25(OH)D deficiency and insufficiency in children with CAP is common. The 25 (OH) D levels are affected by age, disease duration, disease conditions, length of stay, season (duration of sunshine) and other factors, and are correlated with the serum calcium, IgG, IgA, WBC and CRP levels to some extent.