青少年特应性皮炎血清维生素D水平检测及临床意义

Serum vitamin D levels of atopic dermatitis in adolescents and its clinical significance

目的 探讨血清维生素D水平与青少年特应性皮炎严重程度之间的关系。方法 选取2016年3月至2017年2月山西省人民医院收治的特应性皮炎(AD)患者102例为AD组及同期健康体检者100例为对照组,比较两组维生素D值及水平分布情况;根据特应性皮炎评分指数(SCORAD)将AD患者分为轻度组、中度组及重度组,检测三组患者血清25-羟维生素D3[25-(OH)D3]值、总IgE(TIgE)水平及外周血嗜酸性粒细胞百分比(EOS%)。结果 AD组与对照组在维生素D水平分布上比较,差异无统计学意义(χ^2=2.718,P=0.257)。AD组25-(OH)D3水平低于对照组[(18.43±3.73)μg/L比(19.47±3.27)μg/L,t=2.112,P=0.036],维生素D缺乏、不足、足够的25-(OH)D3分别为(11.11±1.65)μg/L、(17.49±1.69)μg/L、(21.73±1.17)μg/L,对照组分别为(12.86±1.47)μg/L、(17.55±1.34)μg/L、(22.05±1.32)μg/L,AD组中维生素D缺乏的水平低于对照组维生素D缺乏的水平(t=2.588,P=0.017),在维生素D不足及足够的水平上比较两组差异无统计学意义(P>0.05)。AD组中轻度40例、中度29例及重度33例,三组患者的血清25-(OH)D3值、TIgE及外周血EOS%差异均有统计学意义(F=6.315、35.813、31.285,均P<0.01)。重度组血清25-(OH)D3低于轻度组(t=3.640,P<0.01),但重度组与中度组及中度组与轻度组差异无统计学意义(P>0.05);在TIgE和外周血EOS%上比较,重度组>中度组>轻度组(t=8.318、8.788,均P<0.01;t=4.322、4.784,均P<0.01);血清25-(OH)D3值与TIgE水平(r=-302,P<0.01)及外周血EOS%(r=-508,P<0.01)呈负相关。结论 青少年AD患者存在维生素D缺乏及不足,低维生素D水平与高TIgE及EOS%有相关性,且AD的严重程度和血清维生素D降低、TIgE水平及外周血EOS%升高关系密切。

Objective To investigate the relationship between the serum level of vitamin D and severity of atopic dermatitis(AD)in adolescents.Methods From March 2016 to February 2017,102 adolescents with AD(AD group)and 100 healthy adolescents(control group)were selected.The distribution and serum levels of vitamin D in the two groups were compared.According to SCORing atopic dermatitis(SCORAD)score,AD patients were divided into mild group,moderate group and severe group.The levels of 25-(OH)D3,total IgE(TIgE)and peripheral blood eosinophil cells percentage(EOS%)were detected in the three groups.Results There was no statistically significant difference in the proportion of patients with vitamin D deficiency,insufficiency and sufficiency between the AD group and control group(χ^2=2.718,P=0.257).The serum level of 25(OH)D3 in the AD group was lower than that in the control group[(18.43±3.73)μg/L vs.(19.47±3.27)μg/L,t=2.112,P=0.036].The mean values of vitamin D deficiency,insufficiency and sufficiency in the AD group were(11.11±1.65)μg/L,(17.49±1.69)μg/L,(21 73±1.17)μg/L,respectively,which in the control group were(12.86±1.47)μg/L,(17.55±1.34)μg/L,(22.05±1.32)μg/L,respectively.The level of vitamin D deficiency in the AD group was significantly lower than that in the control group(t=2.588,P=0.017),but there were no statistically significant differences in vitamin D insufficiency and sufficiency between the AD group and control group.In 102 AD patients,40 cases were mild,29 cases were moderate and 33 cases were severe.The levels of 25-(OH)D3,TIgE and peripheral blood EOS%had statistically significant differences among the three groups(F=6.315,35.813,31.285,all P<0.01).The 25-(OH)D3 level of the severe group was lower than that of the mild group(t=3.64,P=0.097).However,there was no statistically significant difference between the severe and moderate groups and moderate and mild groups(P>0.05).Regarding the TIgE level and EOS%,severe group>moderate group>mild group(t=8.318,8.788,all P<0.01;t=4.322,4.784,all P<0.01).The value of 25-(OH)D3 was negatively correlated with the TIgE level(r=-302,P<0.01)and EOS%(r=-508,P<0.01)in the AD group.Conclusion Vitamin D deficiency or insufficiency exists in adolescents with AD.Low level of vitamin D is correlated with high TIgE level and EOS%.The severity of AD is closely correlated with increased serum levels of TlgE and EOS%,as well as decreased serum levels of vitamin D.