基于倾向性评分匹配法探讨血清维生素A、E对反复呼吸道感染患儿的影响

Effect of serum vitamin A and E on children with recurrent respiratory tract infection based on propensity score matching

目的:探讨血清维生素A、维生素E与反复呼吸道感染之间的关系。方法:1853例反复呼吸道感染患儿入选病例组,2695例健康儿童入选对照组。使用倾向性评分匹配法对两组患者进行匹配,得到组间协变量均衡的样本。使用高效液相色谱法测定血清维生素A和维生素E的水平。采用配对logistic回归模型分析血清维生素A、维生素E对反复呼吸道感染的影响。结果:两组共1507对倾向性评分匹配成功。匹配后病例组与对照组的基本特征之间差异比较均无统计学意义(P>0.05)。匹配后,病例组与对照组维生素A水平比较差异有统计学意义[(0.3±0.1)mg/L vs(0.4±0.4)mg/L,P<0.05]。配对logistic回归分析显示,维生素A水平增高,小儿反复呼吸道感染的发生风险减小(OR=0.46,95%CI:0.22~0.98),维生素A缺乏是小儿反复呼吸道感染的危险因素(OR=1.18,95%CI:1.00~1.38)。维生素E对小儿反复呼吸道感染的影响差异无统计学意义(P>0.05)。结论:本研究未发现血清维生素E对反复呼吸道感染存在显著影响,但是发现血清维生素A与反复呼吸道感染存在关联,因此在小儿反复呼吸道感染临床预防和治疗过程中,应密切监测并适量补充。

Objective To explore the association between vitamin A,E and recurrent respiratory tract infections(RRTIs)in children.Methods 1853 children with RRTIs and 2695 health children were separately selected as cases and controls.Propensity score matching(PSM)analysis were conducted to reducing confounding bias between groups.Blood samples were collected to measure serum levels of vitamins A and E by high performance liquid chromatographie(HPLC).Paired logistic regression was used to determine odds ratios(OR)and 95%confidence intervals(CI)to evaluate the association of RRTIs with the serum levels of vitamin A and E.Results After propensity score estimation and 1∶1 matching,the study cohort included 1507 cases with RRTIs and 1507 health children as controls.The main characteristics between the two groups were all not significantly different after matching(P>0.05).The average levels of vitamin A in two groups were different(P<0.05).Paired logistic regression analysis showed that greater serum levels of vitamin A had a lower risk of RRTIs(OR=0.46,95%CI:0.22-0.98),similarly,deficiency of vitamin A would also increase the risk of RRTIs(OR=1.18,95%CI:1.00-1.38).The statistical difference was not found between VitE and RRTIs(P>0.05).Conclusions The serum levels of vitamin E didn't have a statistically significant association with RRTIs.However,we observed an obvious association between vitamin A and RRTIs.Hence vitamin A clinical monitoring and supplementation are vital for preventing and treating RRTIs.