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目的检测反复呼吸道感染(RRI)患儿血清25-羟维生素D3[25-(OH)D3]及IgA水平,并行维生素D(VitD)治疗,探讨VitD营养状况与儿童RRI及免疫功能的关系,为临床治疗提供依据。方法选取2010年10月-2011年4月在本院儿科门诊就诊的RRI患儿60例为病例组。年龄1～6(3.91±2.83)岁;男32例,女28例。将病例组随机分为常规治疗组30例和补VitD组30例,均予抗感染及对症治疗,补VitD组另进行补VitD治疗。随机选取同期到门诊体检的健康儿童30例为健康对照组。受检儿童均晨起空腹抽取静脉血3 mL 2份,离心,分离血清。ELISA法检测其血清25-(OH)D3水平,免疫透射比浊法检测其血清IgA水平,进行组间比较。病例组3个月时复查血清25-(OH)D3及IgA水平。病例组儿童随访6个月,观察并记录呼吸道感染的复发次数。结果1.病例组血清25-(OH)D3及IgA水平显著低于健康对照组,2组比较差异均有统计学意义(Pa<0.01)。2.采用不同的方法治疗后补VitD组25-(OH)D3及IgA水平升高,常规治疗组和补VitD组RRI次数比较差异有统计学意义(P<0.01)。结论 RRI患儿血清25-(OH)D3及IgA水平低于健康儿童,低水平25-(OH)D3与RRI有关,提示对RRI患儿应重视VitD的补充。
Objective To detect serum 25-hydroxyvitamin D3 [25- (OH) D3] and IgA levels in children with recurrent respiratory tract infection (RRI) and to investigate the relationship between VitD status and RRI and immune function in children with RRI Provide the basis for clinical treatment. Methods From October 2010 to April 2011, 60 children with RRI who were treated in our pediatric clinic were selected as case group. Age 1-6 (3.91 ± 2.83) years; 32 males and 28 females. The case group were randomly divided into routine treatment group 30 cases and VitD group 30 cases, were anti-infective and symptomatic treatment, VitD VitD treatment group. Thirty healthy children were selected randomly from the same period to outpatient examination as healthy control group. Children were inspected in the morning fasting venous blood taken from 2 copies, centrifuged, serum was separated. Serum levels of 25- (OH) D3 were detected by ELISA, serum IgA levels were measured by immunoturbidimetry and compared among groups. Serum 25- (OH) D3 and IgA levels were examined at 3 months in the case group. Children in the case group were followed up for 6 months. The number of recurrent respiratory infections was observed and recorded. Serum levels of 25- (OH) D3 and IgA in case group were significantly lower than those in healthy control group (P <0.01). (2) The levels of 25- (OH) D3 and IgA in VitD group were increased by different methods after treatment, and there was significant difference in the number of RRI between routine treatment group and VitD group (P <0.01). Conclusions Serum levels of 25- (OH) D3 and IgA in children with RRI are lower than those in healthy children and low levels of 25- (OH) D3 are associated with RRI, suggesting that vitamin D supplementation should be emphasized in children with RRI.