血清25(OH)VitD_(3)水平对儿童呼吸道感染常见症状和体液免疫的影响

Effect of Serum 25(OH)VitD_(3) Level on Common Symptoms and Humoral Immunity of Children with Respiratory Tract Infection

目的探讨不同水平血清25(OH)VitD_(3)对儿童呼吸道感染常见症状和体液免疫的影响。方法选择2018年12月-2019年8月南京医科大学第二附属医院儿科收治67例呼吸道感染儿童作为研究对象,根据患儿血清25(OH)VitD_(3)水平将其分为充足组(36例)和不足组(31例),比较两组血清IgA、IgG、IgM及末梢血C-反应蛋白(CRP)水平,比较不同呼吸道感染症状的儿童血清25(OH)VitD_(3)水平,分析血清25(OH)VitD_(3)水平与免疫指标的相关性。结果充足组IgA、IgG、IgM水平均高于不足组,血清CRP水平低于不足组,差异有统计学意义(P<0.05);有喘息症状的儿童血清25(OH)VitD_(3)水平低于无喘息者,差异有统计学意义(P<0.05);有无发热或咳嗽症状患儿血清25(OH)VitD_(3)水平比较,差异无统计学意义(P>0.05);血清25(OH)VitD_(3)水平与IgA、IgG呈正相关,与CRP水平呈负相关,与IgM无相关性。结论血清25(OH)VitD_(3)水平不足可导致儿童体液免疫能力下降,引起患儿呼吸道感染时炎症反应增强,此类患儿更容易出现喘息症状。

Objective To investigate the effect of different levels of serum 25(OH)VitD_(3) on common symptoms and humoral immunity in children with respiratory tract infection.Methods A total of 67 children with respiratory tract infection admitted to the Department of Pediatrics of the Second Affiliated Hospital of Nanjing Medical University from December 2018 to August 2019 were selected as the research objects.According to the serum 25(OH)VitD_(3) level of children,they were divided into sufficient group(36 cases) and insufficient group(31 cases).The serum IgA,IgG,Ig M and peripheral blood C-reactive protein(CRP) levels of the two groups were compared.The serum 25(OH)VitD_(3) levels of children with different respiratory tract infection symptoms were compared.The correlation between serum 25(OH)VitD_(3) level and immune indexes was analyzed.Results The levels of IgA,IgG and IgM in the sufficient group were higher than those in the insufficient group,and the serum CRP level was lower than that in the insufficient group,the difference was statistically significant(P <0.05).The serum 25(OH)VitD_(3) level in children with wheezing symptoms was lower than that in children without wheezing,and the difference was statistically significant( P <0.05).There was no significant difference in serum 25(OH)VitD_(3) level between children with or without fever or cough symptoms(P>0.05).Serum 25(OH)VitD_(3) level was positively correlated with IgA and IgG,negatively correlated with CRP,and had no correlation with IgM.Conclusion The insufficient of serum 25(OH)VitD_(3) can lead to a decrease in humoral immunity in children,which may lead to an increased inflammatory response in children with respiratory tract infection,and may easy to cause the occurrence of wheezing symptoms.