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目的评价急诊重症肺炎患儿维生素D水平与病情的相关性。方法 2009年1月—2012年12月到急诊室救治的161例重症肺炎患儿纳入研究,根据病情是否需要接受机械通气治疗将患儿分为呼吸衰竭组(63例)、肺炎组(98例);入急诊室后立即进行血气分析、生化、凝血、胸片等检查协助诊断及评价病情,采用化学发光法测定儿童就诊当日血清25(OH)D水平。结果 161例患儿男107例,女54例;最小1月,最大12岁;总体25(OH)D水平为(17.43±11.31)ng/ml;呼吸衰竭组、肺炎组患儿血清25(OH)D水平为(12.43±10.11)ng/ml、(20.71±10.07)ng/ml,呼吸衰竭组患儿血清25(OH)D显著低于重症肺炎组(t=4.842,P<0.0001);呼吸衰竭组与肺炎组患儿VitD正常、不足、缺乏及严重缺乏的构成比差异有统计学意义(χ2=17.64,P=0.0005);呼吸衰竭组和肺炎组间PCT水平、多器官损伤程度比较,差异具有统计学意义。结论急诊就诊肺部感染患儿血清25(OH)D越低,器官损伤程度越重、数目越多,补充VitD可能对严重肺部感染患儿有益。
Objective To evaluate the correlation between the vitamin D level and the condition in children with emergency severe pneumonia. Methods A total of 161 severe pneumonia patients admitted to the emergency room from January 2009 to December 2012 were enrolled in the study. Patients were divided into respiratory failure group (63 cases) and pneumonia group (98 cases ); Immediately after entering the emergency room, blood gas analysis, biochemistry, coagulation, chest radiography and other tests to help diagnose and evaluate the condition, the determination of serum 25 (OH) D levels of children on the day of treatment by chemiluminescence. Results There were 161 males and 107 females with 54 females, the lowest was in January and the largest was 12 years old. The total 25 (OH) D level was (17.43 ± 11.31) ng / ml in respiratory failure group and pneumonia group. Serum 25 ) Were significantly lower than those in severe pneumonia group (t = 4.842, P <0.0001). The level of serum D was (12.43 ± 10.11) ng / ml and (20.71 ± 10.07) ng / There were significant differences in the constituent ratios of normal, inadequate, lacking and severe deficiency of VitD between the failure group and the pneumonia group (χ2 = 17.64, P = 0.0005); PCT level and multiple organ damage between respiratory failure group and pneumonia group, The difference was statistically significant. Conclusions The lower the serum 25 (OH) D level in children with acute pulmonary infection is, the more severe organ damage is. The more the number is, the more vitamin D may be beneficial for children with severe pulmonary infection.