不同年龄罹患不同呼吸道疾病儿童维生素A、E的水平分析

Analysis of vitamin A and E levels in children of different ages with different respiratory diseases

目的探讨不同年龄罹患不同呼吸道疾病的儿童维生素A、E水平的差异。方法收集湖南省儿童医院2017年7月至2019年10月呼吸科门诊就诊的671例患儿为疾病组,其中诊断为肺炎197例,反复呼吸道感染152例,哮喘91例,咳嗽变异性哮喘88例,肺炎支原体肺炎143例;同期选取门诊体检的健康儿童245例为正常组,分别采用高效液相色谱法进行定量检测两组血清维生素A、E水平。结果⑴疾病组维生素A水平[(0.31±0.09)mg/L]低于正常组[(0.35±0.25)mg/L],维生素E水平[(8.92±2.57)mg/L]低于正常组[(9.62±2.79)mg/L],差异有统计学意义(P<0.05);⑵疾病组维生素A水平>1~3岁[(0.32±0.09)mg/L]低于同年龄段正常组[(0.35±0.08)mg/L],>3~6岁[(0.30±0.08)mg/L]低于同年龄段正常组[(0.32±0.07)mg/L],差异均有统计学意义(P<0.05);⑶疾病组维生素E水平>1~3岁[(9.23±2.56)mg/L]低于同年龄段正常组[(9.76±2.81)mg/L]、>3~6岁[(8.02±1.86)mg/L]低于同年龄段正常组[(9.67±2.87)mg/L]、>6~14岁[(8.02±1.82)mg/L]低于同年龄段正常组[(9.19±2.58)mg/L],差异均有统计学意义(P<0.05);⑷疾病组不同年龄段维生素A水平比较差异有统计学意义(P<0.05),其中6个月至1岁组处于亚临床缺乏高风险患儿所占比率最大(45.78%),其余各年龄段患儿的维生素A水平处于正常范围所占比率最大;⑸疾病组不同年龄段维生素E水平比较差异有统计学意义(P<0.05),但各年龄段维生素E处于正常范围所占比率最大;⑹肺炎支原体肺炎组患儿体内维生素A、E水平比肺炎组、反复呼吸道感染组、哮喘组、咳嗽变异性哮喘组高,差异有统计学意义(P<0.05),反复呼吸道感染组患儿体内维生素E水平比肺炎组高,差异有统计学意义(P<0.05);咳嗽变异性哮喘组患儿体内维生素E水平比反复呼吸道感染组、哮喘组、肺炎组低,差异有统计学意义(P<0.05)。结论罹患呼吸道疾病患儿维生素A、E水平较正常儿童降低,不同呼吸道疾病及不同年龄段维生素A、E水平有一定差异,在临床上根据不同年龄、不同呼吸道疾病针对性补充维生素A、E可能有重要意义。

Objective To investigate the difference of vitamin A and E levels in children with different respiratory diseases at different ages.Methods A total of 671 children in Hunan Childrens Hospital from July 2017 to October 2019 were selected as the disease group,including 197 cases of pneumonia,152 cases of recurrent respiratory tract infection,91 cases of asthma,88 cases of cough variant asthma and 143 cases of Mycoplasma pneumoniae pneumonia;At the same time,245 healthy children were selected as the normal group.The serum vitamin A and vitamin E levels of the two groups were detected by high performance liquid chromatography(HPLC).Results(1)The vitamin A level[(0.31±0.09)mg/L]of the disease group was lower than the normal group[(0.35±0.25)mg/L,and the vitamin E level[(8.92±2.57)mg/L]was lower than the normal group[(9.62±2.79)mg/L,with statistically significant differ ence(P<0.05);(2)The level of vitamin A in the disease group at the age of>1-3 years[(0.32±0.09)mg/L]was lower than that in the normal group of the same age group[(0.35±0.08)mg/L];the level of vitamin A in the disease group at the age of>3-6 years old[(0.30±0.08)mg/L]was lower than that of the same age group[(0.32±0.07)mg/L],with statistically significant difference(P<0.05);(3)The vitamin E level of the disease group at>1-3 years old[(9.23±2.56)mg/L],>3-6[(8.02±1.86)mg/L]and>6-14 years old(8.02±1.82)mg/L were lower than that of the same age normal group(9.76±2.81)mg/L,(9.67±2.87)mg/L,(9.19±2.58)mg/L],with statistically significant difference(P<0.05);(4)There were significant differences in vitamin A levels among different age in disease group(P<0.05).Among them,the children with high risk of subclinical deficiency accounted for the largest proportion(45.78%)in the 6-month-1-year-oid group,and the proportion of children with normal vitamin A levels in other age groups was the largest;(5)There are significant differences in vitamin E levels in different age groups in the disease group(P<0.05),the levels in the normal range accounts for the largest proportion of all ages;(6)The levels of vitamin A and vitamin E in mycoplasma pneumoniae infection group were increased compared with in recurrent respiratory infection group,asthma group,and cough variant asthma group,and the difference was statistically significant(P<0.05).Compared with the pneumonia group,the level of vitamin E increased in the recurrent respiratory infection group,and the difference was statistically significant(P<0.05);The vitamin E levels in the cough variant asthma group were reduced compared with the repeated respiratory infection group,asthma group and pneumonia group(P<0.05).Conclusions The Vitamin A and E levels of children suffering from respiratory diseases are lower than those of normal children.The Vitamin A and E levels of different respiratory diseases and different age groups are different.Vitamin A and E supplementation may be significantly targeted according to different ages and different respiratory diseases in clinical practice.