0～2岁社区获得性肺炎患儿维生素水平变化及临床意义研究

Changes and significance of vitamin A and vitamin E in children aged 0-2 years with community acquired pneumonia

目的分析0~2岁健康儿童与社区获得性肺炎(CAP)患儿血浆维生素A、E水平,及其与CAP发病的相关性。方法将2016年12月至2018年4月住院治疗的CAP患儿360例纳入CAP组,同期体检健康儿童193例纳入健康组,年龄均为0~2岁。高效液相色谱法(HPLC)检测血浆维生素A、E浓度水平,分析二者与CAP发病的相关性。结果CAP组维生素A及维生素E水平低于健康组(P<0.05),维生素A、E总体缺乏率分别为59.13%(327/553)和2.71%(15/553),CAP组维生素A缺乏率高于健康组(P<0.05),维生素E缺乏率组间比较差异无统计学意义(P>0.05)。维生素E水平低于9.5mg/L是CAP发病危险因素[比值比(OR)=1.590,95%置信区间(95%CI):1.113~2.272,P<0.05],低于6.5mg/L时OR值最大(OR=2.833,95%CI:1.426~5.831,P<0.05)。结论本地区0~2岁CAP患儿维生素A、E水平低于健康儿童,维生素E维持正常水平可能也存在CAP发病风险。

Objective To analyze the vitamin A and vitamin E levels of healthy children and children with community acquired pneumonia(CAP) aged 0-2 years,and to identify the relationship between vitamin A and E and CAP. Methods A total of 360 children with CAP,hospitalized from Dec.2016 to Apr.2018,were enrolled as CAP group,and 193 healthy children were enrolled as control group.High performance liquid chromatography(HPLC) was used to detect the plasma levels of vitamin A and vitamin E,and their relationship with CAP was also analyzed. Results The levels of vitamin A and vitamin E in CAP group were lower than control group( P <0.05).The incidence of vitamin A deficiency in CAP group was higher than control group ( P < 0.05), while there was no statistically significant difference in the incidence of vitamin E deficiency between the two groups ( P > 0.05). Morbidity risk of CAP was increased( OR =1.590,95% CI :1.113-2.272, P <0.05),when level of vitamin E was less than 9.5 mg/L. Conclusion Vitamin A and vitamin E levels of children with CAP aged 0-2 years in this region could be lower than healthy children.There could be morbidity risk of CAP,even when vitamin E level was normal.