维生素A营养状况对学龄前支气管哮喘患儿T淋巴细胞亚群、相关炎症介质及预后转归的影响

Effects of vitamin A nutrition on T lymphocyte subsets, inflammatory mediators and prognosis in preschool children with asthma

目的研究维生素A营养状况对学龄前支气管哮喘患儿T淋巴细胞亚群、相关细胞因子及预后转归的影响,为支气管哮喘防治提供理论依据。方法收集2017年6月-2019年6月鄂东医疗集团黄石市妇幼保健院收治的学龄前支气管哮喘患儿120例的临床资料(病例组),同期选择本院体检的健康的学龄期儿童80例对照组。将病例组按照住院期间维生素A营养状况分为维生素A正常组、维生素A边缘缺乏组、维生素A缺乏组。比较病例组和对照组维生素A营养状况,并记录不同维生素A状况组干预前后T淋巴细胞亚群、相关炎症介质及预后转归。结果病例组维生素A水平[(0.73±0.32)μmol/L]显著低于对照组[(1.02±0.23)μmol/L](t=5.957,P<0.05),且病例组维生素A营养状况显著差于对照组(Z=4.865,P<0.05),维生素A缺乏组治疗后的CD4+、CD4+/CD8+均低于另外两组,CD8+高于另外两组,差异有统计学意义(P<0.05)。维生素A缺乏组治疗后的hs-CRP、EOS、IL-6高于另外两组,差异有统计学意义(P<0.05)。三组治疗临床疗效比较差异有统计学意义(χ2=13.165,P<0.05),其中以维生素A缺乏组临床疗效最差(52.17%),维生素A正常组最高(94.74%)。结论维生素A边缘缺乏或缺乏在学龄前支气管哮喘患儿中较为常见,对患儿细胞免疫功能、炎症反应的改善及疾病的预后转归造成不良影响,临床应当加强患儿维生素A的监测,适时酌情补充维生素A制剂以改善患儿预后。

Objective To investigate the effect of vitamin A nutrition on T lymphocyte subsets, related cytokines and prognosis in preschool children with asthma, in order to provide theoretical evidence for the prevention and treatment of bronchial asthma. Methods A total of 120 preschool children with bronchial asthma admitted to Huangshi Maternal and Child Health Hospital of Edong Medical Group from June 2017 to June 2019 were enrolled in this study, and their clinical data were collected retrospectively.Meanwhile, 80 healthy school-age children in this hospital were selected as control group.According to the nutritional status of vitamin A during hospitalization, the case group was divided into three groups: vitamin A normal group, vitamin A marginal deficiency group and vitamin A deficiency group.The nutritional status of vitamin A was compared between the case group and the control group, and the pulmonary function, T lymphocyte subsets, related inflammatory mediators and prognosis were recorded before and after the intervention. Results The vitamin A level in the case group [(0.73±0.32) μmol/L] was significantly lower than that in the control group [(1.02±0.23) μ mol/L](t=5.957, P<0.05), and the vitamin A nutritional status of the case group was significantly worse than that of the control group(Z=4.865, P<0.05).After treatment, the levels of CD4+, CD4+/CD8+ in vitamin A deficiency group were lower than those in the other two groups, and CD8+ was higher than those in the other two groups(P<0.05).The levels of hs CRP, EOS and IL-6 in vitamin A deficiency group were significantly higher than those in the other two groups(P<0.05).The difference in clinical efficacy among the three groups was statistically significant(χ~2=13.165, P<0.05), with the worst clinical efficacy in the vitamin A deficiency group(52.17%) and the highest in the normal vitamin A group(94.74%). Conclusions Vitamin A marginal deficiency or deficiency is more common in preschool children with bronchial asthma, which is not conducive to the improvement of children′s cellular immune function and inflammatory response, and has a negative impact on prognosis.Clinical monitoring of vitamin A should be strengthened, and vitamin A preparation is suggested to be supplemented appropriately to improve the prognosis of children.