婴幼儿喘息患儿外周血维生素A水平及其辅助治疗效果

Changes in peripheral blood vitamin A level of infants with wheezing and effect of vitamin A adjuvant treatment

目的探讨婴幼儿喘息患儿外周血维生素A(VitA)变化及VitA辅助治疗效果。方法对2016年6月至2019年6月山东省青岛市妇女儿童医院收治的200例婴幼儿喘息患儿(A组)的临床资料与同时期在该院进行体检的186例健康婴幼儿(B组)的体检资料进行回顾性分析。A组中97例患儿(A1组)采用常规治疗,103例患儿(A2组)采用常规治疗结合VitA辅助治疗。比较A、B两组儿童外周血VitA情况,比较A1、A2两组患儿治疗前后的免疫功能及血清细胞因子变化情况,并记录不良反应的发生情况。结果 A组外周血VitA水平低于B组(t=54.495,P<0.05)。A2组治疗总有效率为93.20%,高于A1组的81.44%(χ^(2)=6.317,P<0.05)。A1、A2两组患儿治疗前CD3^(+)、CD4^(+)、CD8^(+)水平差异均无统计学意义(P>0.05),两组治疗后CD3^(+)、CD4^(+)、CD8^(+)水平均高于治疗前(t=4.640~11.481,P<0.05),且A2组均高于A1组(t值分别为3.122、4.428、5.810,P<0.05)。A1、A2两组患儿治疗前白细胞介素-10(IL-10)、IL-17及转化生长因子-β(TGF-β)水平差异均无统计学意义(P>0.05),两组治疗后IL-10、TGF-β水平均高于治疗前(t=6.912~25.929,P<0.05),且A2组均高于A1组(t值分别为11.934、17.762,P<0.05),两组治疗后IL-17水平均低于治疗前(t值分别为56.149、74.283,P<0.05),且A2组低于A1组(t=34.038,P<0.05)。治疗期间A1、A2两组患儿均未出现明显的不良反应。结论婴幼儿喘息患儿外周血VitA水平较低,常规治疗基础上采用VitA辅助治疗可提高疗效,改善患儿免疫功能,且安全性良好。

Objective To investigate changes in vitamin A(VitA) level in peripheral blood of infants with wheezing and effect of VitA adjuvant treatment.Methods The clinical data of 200 infants with wheezing(group A) who admitted to Qingdao Municipal Women and Children′s Hospital of Shandong Province from June 2016 to June 2019 and the physical examination data of 186 healthy infants(group B) who received routine physical examination in the hospital at the same time were retrospectively analyzed.97 infants(group A1) were treated with conventional treatment, and 103 infants(group A2) were treated with conventional treatment combined with VitA adjuvant treatment.VitA level in peripheral blood of the infants in group A and group B was detected and compared, changes in immunologic functions and serum cytokines before and after treatment were compared between subgroup A1 and subgroup A2,and adverse reactions were recorded.Results The VitA level in peripheral blood of the infants in group A was lower than that of the infants in group B(t=54.495,P<0.05).The overall effective rate in subgroup A2 was 93.20%,which was higher than that in subgroup A1(81.44%)(t=6.317,P<0.05).There were no significant differences in serum levels of CD3^(+),CD4^(+) and CD8^(+) before treatment between subgroup A1 and subgroup A2(P>0.05).After treatment, the serum levels of CD3^(+),CD4^(+) and CD8^(+) in the two groups were higher than those before treatment(t=4.640~11.481,P<0.05),and those in subgroup A2 were higher than in subgroup A1(t=3.122,4.428 and 5.810 respectively, P<0.05).There were no significant differences in serum levels of interleukin-10(IL-10),interleukin-17(IL-17) and transforming growth factor-β(TGF-β) before treatment between subgroup A1 and subgroup A2(P>0.05).The serum levels of IL-10 and TGF-β after treatment in the two subgroups were higher than those before treatment(t=6.912~25.929,P<0.05),and the serum levels of IL-10 and TGF-β of the infants in subgroup A2 were higher than those in subgroup A1(t=11.934 and 17.762 respectively, P<0.05).The serum levels of IL-17 after treatment in the two subgroups were lower than those before treatment(t=56.149 and 74.283 respectively, P<0.05),and that in subgroup A2 was lower than group A1(t=34.038,P<0.05).During the treatment, no significant adverse reactions occurred in the infants in the two subgroups.Conclusion The level of VitA in peripheral blood of the young infants with wheezing is low.VitA adjuvant treatment on the basis of conventional treatment can improve therapeutic effect and immunologic functions of the infants, with a good safety.