维生素D对反复呼吸道感染患儿免疫功能和临床疗效的影响

Effect of vitamin D on immune function and clinical efficacy in children with recurrent respiratory infections

目的了解维生素D对反复呼吸道感染(RRI)患儿免疫功能和临床疗效的影响.方法 2017年1月至2018年6月,前瞻性纳入杭州市大江东医院儿科的163例RRI患儿,分为治疗组(85例)和对照组(78例),选择同期65名健康儿童作为健康组.对照组进行常规治疗,治疗组则在此基础上给予阿法骨化醇胶囊3个月,随访12个月,观察对比患儿RRI的次数,检测血清25-羟维生素D3 [25-(OH) D3]、免疫细胞(CD4+、CD8+和CD4+/CD8+)以及免疫球蛋白(IgM、IgA和IgG)水平.结果治疗前,治疗组和对照组患儿25-(OH) D3、IgA、IgM、IgG以及CD4+、CD4+/CD8+水平均低于健康组(P<0.05).至随访结束,治疗组呼吸道感染(2.01±0.48)次,较对照组的(4.23±0.82)次显著减少(t=23.30,P<0.05);血清中25-(OH) D3、IgA、IgM和IgG水平也显著高于对照组(t=35.74、9.99、11.45、26.88,P<0.05);CD4+和CD4+/CD8+水平也较对照组显著升高(t=12.10、3.17,P<0.05).治疗过程中未见明显不良反应发生.结论阿法骨化醇胶囊可显著减少RRI患儿的患病次数,改善患儿血清中25-(OH)D3水平,提高免疫细胞以及免疫球蛋白水平.

Objective To understand the effect of vitamin D on immune function and clinical efficacy in children with recurrent respiratory infections (RRI).Methods From January 2017 to June 2016,163 children with RRI in Dajiangdong Hospital in Hangzhou were prospectively enrolled,and were divided into treatment group (85 cases) and control group (78 cases).There were 65 normal children selected as health group.The control group was given routine RRI treatment,and the treatment group was given Alfacalcidol capsule on the basis of this for 3 months.The number of RRIs in the children,the level of 25-hydroxyvitamin D3 [25-(OH)D3] in the serum,the immune cells including CD4+,CD8+ and CD4+/CD8+,and immunoglobulin including IgM,IgA and IgG levels were evaluated after 12-month follow-up.Results Before the treatment,the levels of 25-(OH)D3,IgA,IgM,IgG,CD4+ and CD4+/CD8+ in treatment group and control group were all lower than those in health group (P<0.05).To the end of follow-up,the times of RRI in treatment group was(2.01±0.48) times,which decreased more significantly comparing with the control group [(4.23±0.82) times](t=23.30,P<0.05).The levels of25-(OH)D3,IgA,IgM and IgG in treatment group were significantly higher than those in control group (t=35.74,9.99,11.45,26.88,P<0.05).The levels of CD4+ and CD4+/CD8+ in treatment group were also higher than those in control group (t=12.10,3.17,P<0.05).There was no adverse drug reaction.Conclusions Alfacalcitol capsules can significantly reduce the number of RRI in children,and can significantly improve serum levels of 25-(OH)D3,as well as Immune cells and immunoglobulins.