血清脂溶性维生素水平与儿童特应性皮炎严重程度的相关性研究

Association between serum levels of fat-soluble vitamins and severity of atopic dermatitis in children

目的探讨脂溶性维生素A、D、E水平与儿童特应性皮炎(AD)发病及疾病严重程度之间的关系,为临床有效防治儿童AD提供理论依据。方法 2018年3月—2020年3月选取海南医学院第二附属医院皮肤科确诊的AD患儿64例为AD组和同期健康体检儿童64例为对照组,通过SCORAD评分评估AD患儿疾病严重程度,采用高效液相色谱法检测血清维生素A(VitA)和维生素E(VitE)水平,采用液相色谱-串联质谱法检测血清25羟基维生素D3[25(OH)D3]水平。结果 AD组血清VitA和25(OH)D3水平均低于对照组,差异有统计学意义(t=3.986、4.312,P<0.05),AD患儿SCORAD评分为(37.8±15.3)分,轻、中、重度AD患儿血清25(OH)D3水平差异有统计学意义(F=9.405,P<0.05),血清25(OH)D3水平与SCORAD评分呈负相关(r=-0.389,P=0.001),血清VitA和VitE水平与SCORAD评分无相关性(P>0.05)。结论 AD患儿存在VitA、VitD缺乏或不足,血清VitD水平与AD严重程度呈负相关。

Objective To investigate the relationship between fat-soluble vitamins(vitamin A,D,E) and the incidence and severity of atopic dermatitis(AD) in children, so as to provide theoretical reference for prevention and treatment of AD in children. Methods A total of 64 AD children diagnosed in the Second Affiliated Hospital of Hainan Medical College were selected as AD group, and 64 healthy children in the same period were recruited into control group.The severity of AD was assessed by the Scoring Atopic Dermatitis(SCORAD).The levels of vitamin A(Vit A) and vitamin E(Vit E) were tested by high performance liquid chromatography, and the level of 25-hydroxy vitamin D3 [25(OH)D3] was determined by liquid chromatography tandem mass spectrometry. Results Compared with control group, the AD group had significantly lower levels of Vit A and Vit E(t=3.986,4.312,P<0.05).The mean SCORAD score of AD children was 37.8±15.3.The difference in serum 25(OH)D3level among mild, moderate and severe AD groups was significantly different(F=9.405, P<0.05).Among AD children, the SCORAD score was negatively correlated with serum 25(OH)D3 level(r=-0.389,P=0.001),but not related to Vit A and Vit E levels(P>0.05). Conclusion Vit A and Vit D deficiency or insufficiency exists in AD children, and the serum Vit D level is negatively correlated with the severity of AD.