不同维生素D水平对过敏性紫癜儿童治疗结局的影响

Effect of different vitamin D levels on the treatment outcome of children with allergic purpura

目的探讨不同维生素D水平对过敏性紫癜儿童治疗结局的影响。方法选取2017年1月~2019年6月在九江市妇幼保健院儿科住院、首次发病确诊为过敏性紫癜的100例患儿,均在治疗前进行25羟基维生素D水平检测,根据治疗前25羟基维生素D水平情况分为对照组(25羟基维生素D≤20 ng/mL,维生素D水平不足,50例)、观察组(25羟基维生素D>20 ng/mL,维生素D水平正常,50例)。两组均在常规治疗的基础上增加维生素D胶囊治疗,并进行随访。比较两组治疗后的临床疗效、随访期间复发情况及随访结束后肾脏损害情况。结果观察组的临床疗效优于对照组,差异有统计学意义(P<0.05)。观察组的治疗总有效率高于对照组,差异有统计学意义(P<0.05);两组治疗前的24 h尿微量清蛋白、尿素氮水平比较,差异无统计学意义(P>0.05);两组治疗后结束随访时的24 h尿微量清蛋白及尿素氮水平均低于治疗前,且观察组的24 h尿微量清蛋白、尿素氮水平均低于对照组,差异有统计学意义(P<0.05);观察组随访期间的复发率低于对照组,差异有统计学意义(P<0.05)。结论较治疗前维生素D水平不足者而言,治疗前维生素D水平正常的过敏性紫癜患儿经治疗后,其24 h尿微量清蛋白、尿素氮水平更低,远期肾脏损害及疾病复发发生率也更低,能获得更好的临床治疗效果。

Objective To explore the effect of different vitamin D levels on the treatment outcome of children with allergic purpura.Methods A total of 100 cases of children diagnosed as allergic purpura admitted to the Department of Pediatrics in Maternal and Child Health Hospital of Jiujiang City for the first time from January 2017 to June 2019 were selected.All the children were tested for 25 hydroxyvitamin D levels before treatment.According to the levels of 25 hydroxyvitamin D before treatment,they were divided into control group(25 hydroxyvitamin D≤20 ng/mL,vitamin D level was insufficient,50 cases)and observation group(25 hydroxyvitamin D>20 ng/mL,vitamin D level was normal,50 cases).Both groups received Vitamin D Capsules in addition to conventional treatment and were followed up.The clinical efficacy,recurrence during the follow-up and kidney damage after the follow-up were compared between the two groups.Results The clinical efficacy of the observation group was better than that of the control group,the difference was statistically significant(P<0.05).The total effective rate of observation group was higher than control group,and the difference was statistically significant(P<0.05).There were no significant differences in 24 h urinary trace albumin and urea nitrogen levels before treatment between the two groups(P>0.05).The 24 h urinary trace albumin and urea nitrogen levels at the end of follow-up after treatment in both groups were lower than those before treatment,and 24 h urinary trace albumin and urea nitrogen levels in the observation group were lower than those in the control group,with statistically significant differences(P<0.05).The recurrence rate in the observation group was lower than that in the control group during the follow-up,and the difference was statistically significant(P<0.05).Conclusion Compared with those with insufficient vitamin D levels,children with allergic purpura with normal vitamin D levels before treatment can obtain better clinical treatment effect after treatment,lower 24 h urinary trace albumin and urea nitrogen levels,long-term renal damage and disease recurrence rates are also lower.It can obtain better clinical therapeutic effect.