反复呼吸道感染患儿Th1/Th2平衡与25羟维生素D的关系分析

Relationship Between Th1/Th2 Balance and 25-hydroxy Vitamin D in Children with Recurrent Respiratory Tract Infection

目的 探讨反复呼吸道感染(RRTI)患儿Th1/Th2平衡与25羟维生素D(25(OH)D)的关系。方法 回顾性分析68例RRTI患儿临床资料,将RRTI患儿纳入观察组,观察组患儿根据预后差异,将预后良好患儿纳入观察1组(n=42,随访将1年内呼吸道感染发病<5次),将预后差患儿观察2组(n=26,随访1年内呼吸道感染发病≥5次),另外纳入68例健康儿作为对照组,比较两组Th1、Th2、Th1/Th2以及25(OH)D水平差异,采用Pearson分析法分析Th1/Th2平衡与25(OH)D的相关性,对比观察1组、观察2组Th1/Th2、25(OH)D水平差异,并应用受试者工作特征(ROC)曲线评估Th1/Th2、25(OH)D水平对预后的预测效能。结果 观察组Th1、Th1/Th2均大于对照组,差异有统计学意义(P<0.05);观察组Th2、25(OH)D水平均小于对照组(P<0.05),差异有统计学意义(P<0.05);Pearson分析结果显示,Th2与25(OH)D呈正相关性,而Th1、Th1/Th2与25(OH)D呈负相关性(P<0.05)。观察1组25(OH)D水平大于观察2组,差异有统计学意义(P<0.05);Th1/Th2的AUC为0.651,95%CI=0.526~0.763,敏感性为45.24%,特异性为84.62%,截断值为≤1.39;25(OH)D的AUC为0.798,95%CI=0.683~0.885,敏感性为92.86%,特异性为50.00%,截断值为>38.99mmol/L。结论 RRTI患儿Th1/Th2与25(OH)D水平关系密切,且上述指标对预后具有一定预测效能,临床诊治RRTI患儿可通过给予补充维生素D,以改善免疫状态,从而改善预后。

Objective To investigate the relationship between Th1/Th2 balance and 25-hydroxy vitamin D(25(OH)D)in children with recurrent respiratory tract infection(RRTI).Methods The clinical data of 68 children with RRTI were retrospectively analyzed,and the children with RRTI were included in the observation group.The children in the observation group were divided into observation group 1(n=42,respiratory tract infection occurred<5 times within 1 year of follow-up)and observation group 2(n=26,respiratory tract infection occurred≥5 times within 1 year of follow-up)according to the prognosis difference,and 68 healthy children were selected as the control group.The levels of Th1,Th2,Th1/Th2 and 25(OH)D were compared between the two groups.Pearson analysis was used to analyze the correlation between Th1/Th2 balance and 25(OH)D.The differences of Th1/Th2 and 25(OH)D levels between observation group 1 and observation group 2 were compared,and the predictive efficacy of Th1/Th2 and 25(OH)D levels on prognosis was evaluated by ROC curve.Results Th1 and Th1/Th2 in the observation group were greater than those in the control group,and the difference was statistically significant(P<0.05).Th2 and 25(OH)D in the observation group were significantly lower than those in the control group(P<0.05),and the difference was statistically significant(P<0.05).Pearson analysis showed that Th2 was positively correlated with 25(OH)D,while Th1,Th1/Th2 were negatively correlated with 25(OH)D(P<0.05).The level of 25(OH)D in observation group 1 was higher than that in observation group 2,and the difference was statistically significant(P<0.05).The AUC of Th1/Th2 was 0.651,95%CI=0.526-0.763,the sensitivity was 45.24%,the specificity was 84.62%,and the cutoff value was≤1.39.The AUC of 25(OH)D was 0.798,95%CI=0.683-0.885,the sensitivity was 92.86%,the specificity was 50.00%,and the cutoff value was>38.99mmol/L.Conclusions Th1/Th2 and 25(OH)D levels in children with RRTI are closely related,and the above indicators have a certain predictive effect on prognosis.In clinical diagnosis and treatment of children with RRTI,vitamin D supplementation can be given to improve the immune status,thereby improving the prognosis.