血清25-羟维生素D3水平测定在毛细支气管炎中的临床意义

Clinical significance of serum 25-hydroxyvitamin D3 level determination in bronchiolitis

目的探讨血清25-羟维生素D3[25-(OH)D3]水平测定在毛细支气管炎中的临床意义。方法选取英德市妇幼保健计划生育服务中心2017年10月~2018年1月收治的106例毛细支气管炎患儿,根据毛细支气管炎诊断标准,分为轻症组及重症组,各53例,作为试验组,同时选择106例门诊同期健康体检儿作为对照组,分别检测三组的血清25-(OH)D3水平。结果重症组的血清25-(OH)D3水平低于轻症组和对照组,轻症组的血清25-(OH)D3水平低于对照组,差异有统计学意义(P<0.05)。重症组的血清25-(OH)D3水平不足率高于轻症组和对照组,轻症组的血清25-(OH)D3水平不足率高于对照组,差异有统计学意义(P<0.05)。重症组的血清25-(OH)D3水平<75 nmol/L患儿的病毒检测阳性率远高于轻症组,差异有统计学意义(P<0.05)。结论毛细支气管炎的发病率可能与维生素D缺乏有关,但过量维生素D会使炎症反应加重,所以孕期、哺乳期及临床工作中需重视婴幼儿维生素D的补充,但是给药方式、剂量等尚需进一步研究。

Objective To investigate the clinical significance of serum 25-hydroxyvitamin D3 (25-[OH]D3) level determination in bronchiolitis. Methods All of 106 children with bronchiolitis admitted to Yingde Maternal and Child Health Family Planning Service Center from October 2017 to January 2018 were divided into mild group and severe group according to the diagnostic criteria of bronchiolitis,53 cases in each group selected as the experimental group,while 106 healthy children in the same period in outpatient clinic were selected as the control group. Serum 25-(OH)D3 level of the three groups was detected respectively. Results The serum level of 25-(OH)D3 in severe group was lower than that of normal infants in mild group and control group (P<0.05). The serum level of 25-(OH)D3 in mild group was lower than that of normal infants in control group,and the differences were statistically significant (P<0.05). The insufficiency rate of serum 25-(OH)D3 level in severe group was higher than that in mild group and control group,and the insufficiency rate of serum 25-(OH)D3 level in mild group was higher than that in control group,and and the differences were statistically significant (P<0.05). The positive rate of viral detection in children with serum 25-(OH)D3 level<75 nmol/L in severe group was much higher than that in children with serum 25-(OH)D3 level<75 nmol/L in mild group,and the difference was statistically significant (P<0.05). Conclusion The incidence of bronchiolitis may be related to vitamin D deficiency,but excessive vitamin D can aggravate inflammation. Therefore,vitamin D supplementation in infants and young children should be paid attention during pregnancy,lactation and clinical work,but the way of administration and dosage of vitamin D should be further studied.