血清25-羟维生素D水平与婴幼儿社区获得性肺炎的发生及严重程度的相关性研究

Correlation between serum 25-(OH)D level and incidence and severity of community acquired pneumonia in infants

目的探讨血清25-羟维生素D[25-(OH)D]水平与婴幼儿社区获得性肺炎(CAP)的发生及严重程度的相关性。方法选取2018年1月—2019年5月蚌埠医学院第一附属医院收治的172例CAP婴幼儿作为CAP组,同期儿科门诊健康体检的50例正常婴幼儿作为对照组,再按照25-(OH)D水平不同将CAP组分为充足组(88例)、不足组(54例)和缺乏组(30例),记录并比较各组间血清25-(OH)D、白细胞计数(WBC)、C反应蛋白(CRP)、降钙素原(PCT)、血沉(ESR)、肺外并发症及病情程度的差异,并统计分析血清25-(OH)D水平与WBC、CRP、PCT、ESR水平的相关性。结果CAP组与对照组比较,25-(OH)D缺乏率分别为48.84%、24.00%,差异有统计学意义(P<0.05);充足组、不足组和缺乏组CRP水平比较差异无统计学意义(P>0.05),在血清25-(OH)D、WBC、PCT、ESR、肺外并发症、病情程度方面比较差异均有统计学意义(均P<0.05),其中缺乏组的WBC、PCT、ESR、肺外并发症的发生率、疾病重症率均高于其他2组,差异有统计学意义(均P<0.05);Spearman秩相关分析显示:血清25-(OH)D水平与WBC、ESR呈负相关(r=-0.444、-0.326,均P<0.05),与CRP、PCT无相关关系(r=0.033、-0.170,均P>0.05)。结论CAP婴幼儿的血清25-(OH)D缺乏率较正常婴幼儿偏高,与疾病的发生及严重程度相关,监测25-(OH)D水平在CAP婴幼儿病情评估中有一定的价值。

Objective To investigate the association between serum 25 hydroxyvitamin D[25-(OH)D]level and incidence and severity of community acquired pneumonia(CAP)in infants.Methods The enrolled participants were all from the First Affiliated Hospital of Bengbu Medical College admitted from January 2018 to May 2019,including 172 infants with CAP as the CAP group and 50 normal infants as the control group.According to different concentrations of 25-(OH)D,the CAP group was divided into adequacy(88 cases),insufficiency(54 cases),and deficiency(30 cases)groups.The differences in serum 25-(OH)D,white blood cell count(WBC),C-reactive protein(CRP),procalcitonin(PCT),erythrocyte sedimentation rate(ESR),extra-pulmonary complications,and severity of disease amongst the three groups were recorded and compared.The correlation between the 25-(OH)D levels of CAP patients with WBC,CRP,PCT,and ESR levels were statistically analysed.Results Comparison of the CAP group with the control group revealed that the 25-(OH)D deficiency rates were 48.84%and 24.00%,respectively,and the difference was statistically significant(P<0.05).No significant difference in CRP levels was observed between the adequate,insufficient,and deficient groups(P>0.05),whereas statistically significant differences were observed amongst the 25-(OH)D,WBC,PCT,ESR,extra-pulmonary complications,and degree of disease in the adequate,insufficient,and deficient groups(all P<0.05).In particular,the levels of WBC,PCT,ESR,incidence of extra-pulmonary complications,and severe disease rate in the deficiency group were higher than those in the other two groups,and the difference was statistically significant(all P<0.05).Spearman rank correlation analysis showed that the serum 25-(OH)D level was negatively correlated with WBC and ESR in the CAP group(r=-0.444,-0.326,P<0.05).No correlation was observed with CRP and PCT level(r=0.033,-0.170,P>0.05).Conclusion The deficiency rate of serum 25-(OH)D in infants with CAP is higher than that of normal infants,which is correlated with the occurrence and severity of the disease.Therefore,monitoring serum 25-(OH)D can aid the assessment of CAP severity in infants.