血清维生素A和25(OH)D水平与儿童过敏性紫癜的相关性

Correlation between the serum levels of vitamin A as well as 25(OH)D and allergic purpura in children

目的探讨维生素A、D水平在过敏性紫癜(HSP)患儿中的表达情况,并分析其与免疫指标之间的相关性。方法收集2018年10月至2019年12月住院治疗的85例HSP患儿及同期门诊体检的80例儿童分别作为HSP组及健康对照组,根据是否合并紫癜性肾炎分为合并紫癜性肾炎的HSPN组(13例)和未合并紫癜性肾炎NHSPN(72例)。分析维生素A、25(OH)D水平与HSP患儿免疫球蛋白和补体的相关性。结果HSP组血清维生素A平均水平(0.26±0.09)mg/L,低于健康对照组的平均水平(0.32±0.06)mg/L,差异有统计学意义(P<0.05)。HSP组25(OH)D平均水平(17.00±7.59)ng/ml,低于健康对照组儿童平均水平(25.07±6.37)ng/ml,差异有统计学意义(P<0.05)。HSPN组患儿血清25(OH)D平均水平(13.19±5.86)ng/ml分别低于NHSPN(17.69±7.70)ng/ml和健康对照组(25.07±6.37)ng/ml,差异有统计学意义(P<0.05)。HSP组患儿25(OH)D与IgA呈负相关(r=-0.232,P<0.05),尚未发现与IgG、IgM、IgE、C3和C4之间存在相关性(P>0.05)。结论HSP患儿血清维生素A、25(OH)D水平均下降。25(OH)D水平下降可能作为HSP是否合并肾损害的预测指标,补充维生素AD可能为HSP治疗提供新思路。

Objective To investigate the expression of vitamin A and D levels in children with Henoch-Schonlein purpura(HSP),and to analyze the correlation between them and immune indicators.Methods Eighty-five children with HSP who were treated in our hospital from October 2018 to December 2019 and eighty healthy examinees were taken as experimental group and control group,respectively.Those in experimental group were subdivided into HSPN group(n=13)and NHSPN group(n=72)according to whether complicated purpura nephritis.The correlation between the serum levels of vitamin A as well as 25(OH)D and immunoglobulin as well as complement in children with HSP.Results The average levels of serum vitamin A and 25(OH)D in experimental group were significantly lower than those in control group(P<0.05).Moreover the average levels of 25(OH)D in HSPN group were significantly lower than those in NHSPN group and control group(P<0.05).In addition,there was a negative correlation between 25(OH)D and IgA in experimental group(r=-0.232,P<0.05),however,there was no correlation between 25(OH)D and IgG,IgM,IgE,C3,C4(P>0.05).Conclusion The serum levels of vitamin A and 25(OH)D in children with HSP are decreases,and the decrease of 25(OH)D level may be refarded as a index to predict whether patients are complicated by renal damage,moreover,vitamin AD supplementation may provide new ideas for treatment.