特应性皮炎与血清脂溶性维生素水平的相关性分析

Relationship between severity of disease and serum levels of fat-soluble vitamins in children with atopic dermatitis

目的探讨脂溶性维生素A、D、E水平与特应性皮炎(AD)疾病严重程度的相关性。方法根据Hanifin-Rajka标准,于2013年—2016年收集AD患儿,以健康体检儿童作对照;应用SCORAD方法评估AD患儿疾病严重程度;酶联免疫法检测血清总IgE水平;血细胞分析仪检测嗜酸性细胞绝对计数值;高效液相色谱法测定血清视黄醇、25-(OH)D3水平,液相质谱法测定血清维α-生育酚水平。结果共纳入AD患儿61例,对照组48例。AD患儿SCORAD评分为(44.71±16.06)。AD患儿血清25-(OH)D3水平为(33.88±1.03)nmol/L,低于对照组的(50.49±1.90)nmol/L;血清视黄醇水平为(0.83±0.03)μmol/L,低于对照组的(0.93±0.04)μmol/L,差异均有统计学意义(P<0.05)。AD组和对照组之间血清α-生育酚水平的差异无统计学意义(P>0.05)。AD患儿血清视黄醇、25-(OH)D3水平与SCORAD呈显著负相关(P<0.05),α-生育酚水平与SCORAD无相关性(P>0.05)。结论AD患儿维生素A、D水平均下降,且与疾病严重程度相关。

Objective To explore the correlation between fat-soluble vitamins A,D,E and the severity of atopic dermatitis(AD).Method According to the Hanifin-Rajka criteria,61 children with AD were enrolled in this study.The SCORing Atopic Dermatitis(SCORAD)index was used to evaluate the severity of disease.The serum total IgE level was detected by enzyme-linked immunosorbent assay.The levels of serum retinol and 25-(OH)D3 were determined by high performance liquid chromatography.The levels ofα-tocopherol in serum were assessed by high-performance liquid chromatography-mass spectrometry/mass spectrometry.Result There were 61 AD patients and 48 healthy controls included.The mean SCORAD scores was 44.71±16.06(ranged from 22 to 74.36).The serum level of 25-(OH)D3 in patients with AD(33.64±7.46 nmol/L)was significantly different from that in the control subjects(52.61±14.56 nmol/L)(P<0.001).The mean serum levels of retinol in AD children(0.83±0.03μmol/L)was significantly lower than those of healthy controls(0.93±0.04μmol/L)(P=0.0313).There was no difference in the levels ofα-tocopherol between AD patients and healthy controls(18.71±0.55μmol/L and 19.87±0.57μmol/L,respectively).Both retinol and 25-(OH)D3 showed a negative correlation with SCORAD scores(P=0.0277,P=0.0121).There was no relationship between serum levels ofα-tocopherol and AD severity(P=0.96).Conclusion The levels of vitamin A,D and E were not adequate in AD patients,and the level of vitamin A and D were negatively correlated with the severity of the disease.