血清25-羟维生素D水平与毛细支气管炎严重程度的相关性研究

Research on the association between the concentration of 25 hydroxyvitamin D in serum and severity of bronchiolitis

目的研究血清25-羟维生素D水平与毛细支气管炎患儿病情严重程度的关系,以及应用骨化三醇干预对毛细支气管炎所产生的效果,为评估毛细支管炎的病情和预后提供新的方法,并为骨化三醇辅助治疗毛细支管炎提供理论依据。方法选择2018—2019年本院儿科诊治的毛细支气管炎患儿161例为观察组,随机抽取本院同时期儿童保健科的正常婴幼儿43例作为对照组,检测并比较血清25-羟维生素D水平。依据患儿病情,将观察组进一步分为轻度组、中度组和重度组,并将中度组的65例患儿按数表法分为常规治疗组及骨化三醇组,骨化三醇组在常规治疗基础上加服骨化三醇0.25μg/d,干预2周。比较常规治疗组33例与骨化三醇组32例的喘息天数、住院天数、住院费用等情况。结果毛细支气管炎患儿血清25-羟维生素D的平均浓度为(20.62±3.83)nmol/L,显著低于对照组儿童的(32.19±1.70)nmol/L,差异有统计学意义(P<0.05);轻度组血清25-羟维生素D的平均浓度(24.60±2.54)nmol/L,中度组平均浓度(19.51±2.60)nmol/L,重度组平均浓度(17.24±2.49)nmol/L,病情越重,血清25-羟维生素D水平越低,差异有统计学意义(F=19.31,P<0.05)。骨化三醇组患儿喘息天数(5.34±1.36)天,住院天数(9.45±1.52)天,住院费用(3067.53±626.13)元,均较常规治疗组少,差异有统计学意义(P<0.05)。结论毛细支气管炎患儿普遍存在维生素D缺乏,血清25-羟维生素D水平越低,病情越重。在治疗过程中,及时补充骨化三醇,有助于缓解症状,缩短病程,降低治疗费用。

Objective To analyze the association between concentration of 25 hydroxyvitamin Din serum and the severity of bronchiolitis,and the intervention effect of calcitriol on bronchiolitis,so as to provide a new way for evaluating the condition and prognosis of patient,and also provides a theoretical basis for the adjuvant treatment of bronchiolitis with calcitriol.Methods 161 children with bronchiolitis those who were treated in our hospital from 2018 to 2019 were selected as the observation group,and 43 normal infants received child care in our hospital during the them period were chosen to be the control group.Concentrations of 25 hydroxyvitamin D in serum in both two groups were detected.According to the disease condition,patients in the observation group were divided into three groups including mild group,medium group,and severe group.The 65 cases of children with moderate bronchiolitis in the observation group were further split into conventional treatment group and calcitriol group.Patients in thecalcitriol group was supplemented with 0.25 ug calcitriol every day for 2 weeks besides routine treatment of bronchiolitis.The wheezing days,hospitalization days and hospitalization expenses of the conventional treatment group and calcitriol group were compared.Results The average concentration of 25 hydroxyvitamin D in children with bronchiolitis was(20.62±3.83)nmol/L,which was significantly lower than that in normal infants(32.19±1.70)nmol/L,and the difference was statistically significant(P<0.05).Among the children with bronchitis,the average concentration of 25 hydroxyvitamin D in mild group was(24.60±2.54)nmol/L,in moderate group was(19.51±2.60)nmol/L,and in severe group was(17.24±2.49)nmol/L respectively.The more severe the disease was,the lower the serum 25 hydroxyvitamin D level was,and the difference was statistically significant(F=19.31,P<0.05).The wheezing days(5.34±1.36),hospitalization days(9.45±1.52)and the medical care costs(3067.53±626.13)yuan in the calcitriol group were significantly lower than those in the conventional treatment group(P<0.05).Conclusions Vitamin D deficiency is common in children with bronchiolitis.The lower the serum 25 hydroxyvitamin D level is,the more serious the disease is.In the treatment process,timely supplement of calcitriol could help relieve symptoms,shorten the course of disease and reduce the cost of treatment.