维生素D缺乏与小婴儿毛细支气管炎发病的关系

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目的研究VitD缺乏与小婴儿毛细支气管炎以及免疫力低下的关系。方法选择毛细支气管炎患儿60例,随机分为VitD治疗组和非VitD治疗组。以同期收治的普通肺炎患儿30例(肺炎组)作为对照。应用生化法检测血钙及血磷水平,全血干化学免疫浓缩法检测血清AKP水平,ELISA法检测血清25-(OH)D3水平,免疫透射比浊法测定血清IgA水平;同时记录患儿临床症状的缓解时间以及住院天数。结果 1.VitD治疗组喘憋消失时间、住院时间均较非VitD治疗组减少,二组比较差异均有统计学意义(Pa<0.05)。VitD治疗组转入ICU比率显著低于非VitD治疗组(P<0.05);VitD治疗组28例(93.3%)痊愈,非VitD治疗组21例(70%)痊愈,二组比较差异有统计学意义(P<0.05)。2.毛细支气管炎组与肺炎组血清25-(OH)D3、AKP、IgA水平比较差异均有统计学意义(Pa<0.01)。3.毛细支气管炎患儿治疗前后血清AKP、25-(OH)D3及IgA水平差异均有统计学意义(Pa<0.01)。4.毛细支气管炎患儿血清IgA水平与25-(OH)D3水平呈正相关(r=0.61,P<0.05)。结论 VitD缺乏与小婴儿毛细支气管炎发病及免疫力低下密切相关。在毛细支气管炎的治疗过程中,补充VitD可及时缓解临床喘憋症状,且明显缩短其病程;VitD缺乏可能是毛细支气管炎的潜在病因。 Objective To investigate the relationship between VitD deficiency and bronchiolitis in infantile infants and low immunity. Methods Sixty children with bronchiolitis were randomly divided into VitD group and non-VitD group. In the same period admitted to ordinary children with pneumonia in 30 cases (pneumonia group) as a control. Serum calcium and phosphorus levels were measured by biochemical methods. Serum AKP level was measured by whole blood dry chemical immunostaining method. Serum 25- (OH) D3 level was measured by ELISA. Serum IgA level was measured by immunoturbidimetry. At the same time, Symptom relief time and length of stay. Results 1.VitD treatment group wheezing disappear time, hospital stay than non-VitD treatment group decreased, the difference between the two groups were statistically significant (Pa <0.05). VitD treatment group into the ICU rate was significantly lower than non-VitD treatment group (P <0.05); VitD treatment group 28 cases (93.3%) cured, non VitD treatment group 21 cases (70%) cured, the difference was statistically significant Significance (P <0.05). The serum levels of 25- (OH) D3, AKP, IgA in bronchiolitis group and pneumonia group were significantly different (P <0.01). 3. The serum levels of AKP, 25- (OH) D3 and IgA in patients with bronchiolitis before and after treatment were significantly different (Pa <0.01). Serum IgA levels in children with bronchiolitis were positively correlated with 25- (OH) D3 levels (r = 0.61, P <0.05). Conclusions VitD deficiency is closely related to the onset and immunocompromise of bronchiolitis in infants. In the treatment of bronchiolitis, VitD supplementation can relieve clinical symptoms of wheezing and significantly shorten the course of disease; VitD deficiency may be the underlying cause of bronchiolitis.
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