学龄前期反复呼吸道感染患儿的发育及免疫特点

Developmental and immune characteristics of children with recurrent respiratory tract infection in preschool age

目的探究学龄前期反复呼吸道感染(RRTI)患儿的发育及免疫特点。方法选取2021年1月至12月在广西中医药大学附属瑞康医院及扶绥县妇幼保健院就诊的80例>3~<7岁RRTI患儿作为研究组,另选取同期健康体检的80例>3~<7岁儿童为对照组。比较两组身高、体重及血清维生素A、D、锌水平及T淋巴细胞亚群、生长激素、胰岛素样生长因子1(IGF-1)水平,并分析相关性。结果研究组平均身高、平均体重、体重指数低于对照组,身高、体重百分位处于P3以下及P3~10百分位率高于对照组,处于P11~P95,>P95百分位率低于对照组(P<0.05)。研究组血清维生素A、D及锌水平低于对照组。研究组的CD3^(+)T、CD4^(+)T、CD4^(+)T/CD8^(+)T及生长激素、IGF-1水平低于对照组,而CD8^(+)T水平高于对照组(P<0.05)。RRTI发生频率与生长激素、IGF-1、维生素A、D及锌、CD3^(+)T、CD4^(+)T、CD4^(+)T/CD8^(+)T水平呈负相关,与CD8^(+)T水平呈正相关(P<0.01)。生长激素、IGF-1与血清维生素A、D及锌、CD3^(+)T、CD4^(+)T、CD4^(+)T/CD8^(+)T水平呈正相关,与CD8^(+)T水平呈负相关(P<0.01)。结论RRTI患儿常伴有不同程度的维生素缺乏,生长激素、T淋巴细胞亚群、IGF-1水平低于正常儿童,临床应及时进行干预,且注意调整患儿膳食及补充营养物质,以促进机体正常发育,降低RRTI的发生频率。

Objective To explore the developmental and immune characteristics of children with recurrent respiratory tract infection(RRTI)in preschool age.Methods A total of 80 RRTI children aged>3 to<7 years old who were treated in Ruikang Hospital Affiliated to Guangxi University of Chinese Medicine and Fusui Maternal and Child Health Hospital from January to December 2021 were selected as the study group,and 80 children aged>3 to<7 years old who underwent physical examination during the same period were selected as the control group.The height,weight,serum levels of vitamin A,D,zinc and T lymphocyte subsets,growth hormone,and insulin-like growth factor-1(IGF-1)were compared between the two groups,and the correlation was analyzed.Results The average height,average weight and body mass index of the study group were lower than those of the cont rol group,the percentile rates of height and weight below P3 a nd P3-10 were higher than those of the control group,the percentile rates of P11-P95 and>P95 were lower than those of the control group(P<0.05).The serum levels of vitamin A,D and zinc in the study group were lower than those in the control group.The levels of CD3^(+)T,CD4^(+)T,CD4^(+)T/CD8^(+)T,growth hormone and IGF-1 in the study group were lower than those in the control group,while the level of CD8^(+)T was higher than that in the control group(P<0.05).The frequency of RRTI was negatively correlated with the levels of growth hormone,IGF-1,vitamin A,D,zinc and CD3^(+)T,CD4^(+)T,CD4^(+)T/CD8^(+)T,and positively correlated with the level of CD8^(+)T(P<0.01).The levels of growth hormone and IGF-1 were positively correlated with serum vitamin A,D,zinc and CD3^(+)T,CD4^(+)T,CD4^(+)T/CD8^(+)T,and negatively correlated with CD8^(+)T(P<0.01).Conclusion Children with RRTI are often accompanied by varying degrees of trace vitamin deficiency,and the levels of growth hormone,T lymphocyte subsets,and IGF-1 are lower than those of normal children.Clinical intervention should be carried out in time,and attention should be paid to adjust the children’s diet and supplement nutrients to promote the normal development of the body and red uce the frequency of RRTI.