儿童特应性皮炎严重程度与血清维生素D及免疫指标水平的相关性分析

The correlation between severity of atopic dermatitis and serum levels of vitamin D and immune indexes in children

目的探讨特应性皮炎(AD)患儿血清维生素D(VD)、C-反应蛋白、白细胞介素(IL)-6、肿瘤坏死因子-α、总免疫球蛋白E(tIgE)水平及外周血细胞计数与疾病严重程度的相关性。方法67例AD患儿即AD组,根据病情严重程度分为轻中度AD组(37例)、重度AD组(30例),另选取同期健康体检的儿童50例作为对照组。检测AD患儿的血清dgE水平,比较轻中度/重度AD组与对照组的血常规、血清25(OH)D、C-反应蛋白、及IL-6、肿瘤坏死因子-a等指标水平。结果重度AD组VD不足的比例为61.3%,高于轻中度AD组(30.6%)和对照组(34.0%)。AD组的白细胞计数、嗜酸性粒细胞百分比、血小板计数及IL一6水平均高于对照组(P<0.05),但25(OH)D的组间差异无统计学意义(P>0.05)。重度AD组的tIgE、IL-6高于轻中度AD组(P<0.05),25(OH)D低于轻中度AD组(P<0.05)。AD组SCORAD评分与25(OH)D呈负相关(r=-0.696,P<0.05),与IL-6与呈正相关(r=0.544,P<0.05)。AD组25(OH)D与IL-6呈负相关(r=-0.379,P=0.03)。结论血清VD水平与儿童AD严重程度有一定相关性,VD与IL-6可能共同参与儿童AD的发病。

Objective To investigate the correlation between serum levels of vitamin D(VD),C-reactive protein,interleukin(IL)6,tumor necrosis factor alpha,total level of immunoglobulin E(tIgE),peripheral blood cell count and the severity of disease in children with atopic dermatitis(AD).Methods 67 cases of children with AD or AD groups,according to the illness severity was divided into mild-to-moderate AD group(37 cases),severe AD group(30 cases),the other to choose the healthy check-up of 50 cases of children for the same period as the control group.Detection of serum tlgE children with AD level,compared with mild-to-moderate/severe AD group and control group routine blood,serum 25(OH)D,C-reactive protein,and IL-6 and tumor necrosis factor alpha level indicators.Results The incidence of vitamin D insufficient in severe group(61.3%)was higher than that of the mild-to-moderate group(30.6%)and the control group(34.0%).Compared to the control group,WBC,percentage of cosinophils,PLT and IL-6 were significantly higher in AD group(P<0.05,respectively).25(OH)D was not significandy different between AD and control groups(P>0.05).IL-6 and tIgE in severe group were higher than that in mild to moderate group,whereas 25(OH)D was lower.(P<0.05,respectively).Scoring atopic dermatitis score in AD group was negatively correlated with 25(OH)D(r=-0.696,P<0.05),and positively correlated with IL-6(r=0.544,P<0.05).There was a negative correlation between 25(OH)D and IL-6 in AD group(r=-0.379,P=0.03).Conclusion Serum level of VD has some correlation with severity children AD,and VD and IL-6 may joindy participate in the pathogenesis of AD in children.