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目的探讨血清25(OH)D_3水平与婴幼儿毛细支气管炎严重程度的关系。方法选取住院治疗的180例毛细支气管炎患儿为研究对象,根据临床表现分为轻症组100例和重症组80例;同时选取儿童保健体检的健康婴幼儿100例作为对照组,分别检测各组婴幼儿的血清25(OH)D_3水平行组间比较。同时重症毛细支气管炎患儿随机分为Vit D治疗组和非Vit D治疗组各40例,测定两组治疗前、后的血清25(OH)D_3及免疫球蛋白水平并进行比较。记录各组患儿临床症状的缓解时间,包括咳嗽、喘息、吸气三凹征、肺部啰音消失时间、血氧饱和度改善时间及住院时间。结果重症组患儿的血清25(OH)D_3水平显著低于轻症组患儿及对照组婴幼儿,且症状越重25(OH)D_3水平越低;Vit D治疗组患儿喘憋、咳嗽、啰音消失时间、住院时间均少于非Vit D治疗组患儿,差异均有统计学意义(P<0.05)。重症组患儿Vit D治疗组和非Vit D治疗组治疗前的血清25(OH)D_3及免疫球蛋白水平差异均无统计学意义(P>0.05),治疗后Vit D治疗组25(OH)D_3水平及Ig A、Ig G显著高于非Vit D治疗组,差异有统计学意义(P<0.05),Ig E、Ig M水平差异无统计学意义(P>0.05)。结论婴幼儿毛细支气管炎严重程度与Vit D缺乏有关,在治疗毛细支气管炎的过程中,补充足量的Vit D可以及时缓解临床喘憋症状,调节患儿免疫功能,缩短其病程,Vit D缺乏可能是毛细支气管炎加重的原因之一。
Objective To investigate the relationship between serum 25 (OH) D_3 and the severity of bronchiolitis in infants. Methods A total of 180 cases of bronchiolitis were selected as study subjects. According to clinical manifestations, 100 cases were divided into mild group and 80 severe cases. 100 healthy children and adolescents were selected as control group, Serum 25 (OH) D_3 levels in infants and young children were compared between groups. At the same time, children with severe bronchiolitis were randomly divided into Vit D treatment group and non-Vit D treatment group 40 cases. Serum 25 (OH) D 3 and immunoglobulin levels before and after treatment were measured and compared. The relief time of clinical symptoms in each group was recorded, including cough, wheezing, three concave signs of inspiratory, disappearance of pulmonary rales, time of oxygen saturation improvement and hospital stay. Results Serum levels of 25 (OH) D 3 in children with severe disease were significantly lower than those in children with mild disease and those in the control group, and the more severe 25 (OH) D_3 was. The Vit D treatment group had wheezing and coughing , The time of rales disappearing and hospital stay were less than those of non-Vit D treatment group, the difference was statistically significant (P <0.05). Serum 25 (OH) D 3 and immunoglobulin levels were not significantly different between the Vit D group and the non-Vit D group before treatment (P> 0.05) The levels of D_3 and Ig A, Ig G were significantly higher than those of non-Vit D treatment group (P <0.05). The levels of Ig E and Ig M were not significantly different (P> 0.05). Conclusions The severity of bronchiolitis in infants is related to Vit D deficiency. In the process of treating bronchiolitis, supplementation of adequate Vit D can relieve clinical symptoms of wheezing, regulate immune function and shorten the course of disease, and Vit D deficiency May be one of the reasons for the increased bronchiolitis.