血清25-羟基维生素D_3检测在儿童社区获得性肺炎中的应用价值

Application value of serum 25-hydroxyvitamin D_3 detection in children with community-acquired pneumonia

目的探讨血清25-羟基维生素D_3[25-(OH)D_3]在儿童社区获得性肺炎中的变化及临床意义。方法选择2018年1～6月间西安市第一医院收治的128例社区获得性肺炎患儿为研究对象,根据病情程度分为轻症组(n=80)及重症组(n=48),选择健康儿童50例纳入对照组。比较不同组受检者血清25-(OH)D_3、超敏C反应蛋白(hs-CRP)水平,以及维生素D充足组(n=51)及维生素D缺乏组(n=77)患儿的临床疗效。结果轻症组及重症组患儿血清25-(OH)D_3水平分别为(73.45±12.63) nmol/L、(68.36±11.74) nmol/L,均明显低于对照组的(81.64±11.52) nmol/L,血清hs-CRP水平分别为(11.28±3.36) mg/L、(16.61±4.54) mg/L,均明显高于对照组的(3.67±1.17) mg/L,重症组患儿血清25-(OH)D_3水平明显低于轻症组,血清hs-CRP水平则明显高于轻症组,差异均有统计学意义(P<0.05);维生素D充足组患儿临床症状体征消退时间、住院时间分别为(7.16±2.14) d、(9.24±3.25) d,明显短于维生素D缺乏组的(9.93±3.29) d、(12.26±4.42) d,差异均有统计学意义(P<0.05)。结论血清25-(OH)D_3的缺乏与儿童社区获得性肺炎的发生关系密切,25-(OH)D_3水平不仅可以反映疾病的轻、重程度,且可以影响临床疗效。

Objective To investigate the changes and clinical significance of serum 25-hydroxyvitamin D3(25-(OH)D3) in children with community-acquired pneumonia. Methods From January 2018 to June 2018, 128 cases of children with community-acquired pneumonia treated in Xi’an First Hospital were divided into the mild group(n=80)and evere group(n=48) according to the degree of the disease. Fifty healthy children undergoing physical examination in the same period were selected as the control group. The serum levels of 25-(OH)D3, hs-CRP, and the clinical effects of the vitamin D adequacy group(n=51) and vitamin D deficiency group(n=77) were compared among the different groups. Results The serum levels of 25-(OH)D3in children with community acquired pneumonia(mild group and severe group) were(73.45 ± 12.63) nmol/L,(68.36 ± 11.74) nmol/L, respectively, which were significantly lower than(81.64±11.52) nmol/L in the control group;the serum levels of hs-CRP were(11.28±3.36) mg/L,(16.61±4.54) mg/L, respectively, which were significantly higher than(3.67 ± 1.17) mg/L in the control group(P<0.05). The serum levels of25-(OH)D3in the severe group were significantly lower than those in the mild group, and the serum levels of hs-CRP were significantly higher than those in the mild group(P<0.05). In the adequate vitamin D group, the clinical symptoms and signs subsidence time and hospitalization time of were(7.16±2.14) d,(9.24±3.25) d, respectively, which were significantly shorter than corresponding(9.93 ± 3.29) d,(12.26 ± 4.42) d of the children with vitamin D deficiency(P<0.05).Conclusion The deficiency of serum 25-(OH)D3is closely related to the occurrence of community acquired pneumonia in children, and the level of 25-(OH)D3can reflect the severity of the disease and affect the clinical efficacy.