维生素D营养状况与儿童支气管肺炎发生及转归的关系研究

Study on The Relationship Between Vitamin D Nutritional Status and The Occurrence and Outcome of Bronchial Pneumonia in Children

目的:探讨维生素D营养状况与儿童支气管肺炎发生及临床转归的关系。方法:收集2020年9月—2022年10月在我院儿科收治的123例支气管肺炎患儿和同期154例健康体检健康儿童为研究对象。收集两组儿童一般情况、身高、体重等信息,检测两组儿童血清25(OH)D_3水平,收集支气管肺炎患儿的临床转归情况。采用Spearson相关分析维生素D营养状况与支气管肺炎发生及临床转归的相关性,维生素D营养状况对支气管肺炎发生的影响采用多元Logistic回归分析。结果:支气管肺炎组患儿血清25(OH)D_3水平显著低于正常组儿童[(18.36±2.42)vs(20.92±2.65)] ng/mL,且维生素D不足/缺乏发生率高于正常组组[(45/78) vs(24/130),P<0.05],且血清25(OH)D_3水平与支气管肺炎的发生呈显著负相关(r=-0.603, P<0.05)。户外活动时间≥2h及维生素D补充是发生支气管肺炎的保护因素(OR<1, P<0.05),而维生素D不足/缺乏是支气管肺炎的危险因素(OR>1, P<0.05)。转归良好组患者血清25(OH)D_3水平显著高于转归不良组[(21.04±2.87)vs (19.03±2.47)] ng/mL,且维生素D不足/缺乏率低于转归不良组[(22/67 vs 23/11),均有P<0.05],且血清25(OH)D_3水平与支气管肺炎的转归良好呈显著正相关(r=0.586, P<0.05)。结论:支气管肺炎患儿维生素D营养状况较差,维生素D营养状况与支气管的发生呈负相关,与临床转归良好呈正相关。支气管肺炎易感儿童应保持机体储存充足的维生素D,以预防支气管肺炎的发生发展。

【Objective】To investigate the relationship between vitamin D nutritional status and the occurrence and clinical outcome of bronchial pneumonia in children.【Method】Totally123 children with bronchial pneumonia admitted to the pediatric department of our hospital from September 2020 to October 2022 and 154 healthy children with health check-ups during the same period were collected for the study.Information on general condition,height and weight of children in both groups were collected,serum 25(OH)D3 levels of children in both groups were tested,and clinical outcome of children with bronchial pneumonia was collected.Spearson correlation was used to analyze the correlation between vitamin D nutritional status and the occurrence and clinical outcome of bronchial pneumonia,and the effect of vitamin D nutritional status on the occurrence of bronchial pneumonia was analyzed by multiple logistic regression.【Result】Children in the bronchial pneumonia group had significantly lower serum 25(OH)D3 levels than children in the normal group[(18.36±2.42)vs(20.92±2.65)]ng/mL,and the incidence of vitamin D insufficiency/deficiency was higher than in the normal group[(45/78)vs(24/130),P<0.05],and there was a significant negative correlation between serum 25(OH)D3 levels and the occurrence of bronchial pneumonia(r=-0.603,P<0.05).Outdoor activity time≥2 h and vitamin D supplementation were protective factors for the development of bronchial pneumonia(OR<1,P<0.05),whereas vitamin D insufficiency/deficiency was a risk factor for bronchial pneumonia(OR>1,P<0.05).Serum 25(OH)D3 levels were significantly higher in patients in the good outcome group than in the poor outcome group[(21.04±2.87)vs(19.03±2.47)]ng/mL,and vitamin D insufficiency/deficiency was lower than in the poor regression group[(22/67 vs 23/11)],both with P<0.05,and serum 25(OH)D3 levels were significantly and positively correlated with good outcome of bronchial pneumonia(r=0.586,P<0.05).【Conclusion】Vitamin D nutritional status is poor in children with the bronchial pneumonia,and vitamin D nutritional status is negatively correlated with the occurrence of bronchial pneumonia and positively correlated with good clinical outcome.Bronchopneumonia-prone children should maintain adequate vitamin D stores in the body to prevent the development of the bronchial pneumonia.