维生素D对婴幼儿特应性皮炎的影响

Effects of Vitamin D on Atopic Dermatitis in Infants

目的探讨血清维生素D[25-(OH)D]对婴幼儿特应性皮炎(AD)的影响。方法纳入2019年1月至2019年12月在广州医科大学附属顺德医院就诊的114例AD患儿,以是否合并其他过敏性疾病分为单纯组56例,混合组58例,调查研究对象的基本临床资料。采集静脉血分别检测两组患儿25-(OH)D,总免疫球蛋白E(tIgE),过敏原特异性免疫球蛋白E(sIgE),嗜酸性粒细胞比例(EO%)和计数(EO#),采用SPSS 19.0统计软件对检测结果进行数据分析。结果单纯组25-(OH)D水平为27.82±4.44 ng/mL,不足比例为37例(66.1%),充足比例为19例(33.9%);混合组25-(OH)D水平为24.43±4.32 ng/mL,不足比例50例(86.2%),充足比例为8例(13.8%)。两组患儿在湿疹面积、25-(OH)D水平和不足比例、总免疫球蛋白E水平、食物和吸入性过敏原特异性免疫球蛋白E检出率、嗜酸性粒细胞比例和计数方面差异有统计学意义(均P<0.05)。在Logistic回归模型中,调整年龄、性别、体重、家族史、喂养方式、添加辅食时间等混杂因素后,AD患儿25-(OH)D<30 ng/mL增加患其他过敏性疾病的风险(Adjusted OR=3.46,95%CI:1.74~5.28)。结论AD患儿维生素D水平不足增加其他过敏性疾病的发病率,这可能是特应性进程的危险因素。

Objective To investigate the effect of serum vitamin D[25-(OH)D]in infants with atopic dermatitis(AD).Methods A total of 114 infants with AD were enrolled in Shunde Hospital affiliated to Guangzhou Medical University from January,2019 to December,2019.According to whether they were complicated with other allergic diseases,all sujects were divided into the simple group(n=56)and mixed group(n=58).The basic clinical data of the subjects were investigated.Venous blood samples were collected for the detection of 25-(OH)D,total immunoglobulin E(tIgE),allergen specific immunoglobulin E(sIgE),eosinophil ratio(EO%)and count(EO#),and the test results were analyzed by SPSS19.0 statistical software.Results In the simple group,the content of 25-(OH)D was 27.82±4.44 ng/mL,leading to insufficient in 37 cases(66.1%)and sufficient in 19 cases(33.9%).In the mixed group,the 25-(OH)D content was 24.43±4.32 ng/mL,leading to insufficient in 50 cases(86.2%),and the sufficient in 8 cases(13.8%).There were significant differences in eczema area,25-(OH)D content and deficiency ratio,total immunoglobulin E content,food and inhalation allergen specific immunoglobulin E detection rate,eosinophil proportion and count between the two groups(all P<0.05).Using logistic regression model,after adjusting for the confounding factors such as age,sex,body weight,family history,feeding method and supplementary feeding time,25-(OH)D<30ng/mL in infants with AD increased the risk of other allergic diseases(adjusted OR=3.46,95%CI:1.74,5.28).Conclusion Vitamin D deficiency in infants with AD increases the incidence of other allergic diseases,which may be a risk factor for atopic march.