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目的分析反复上呼吸道感染患儿血清微量(锌、铁)和常量元素(镁)缺乏情况,并观察间断补锌、铁的防治效果。方法以该院2014年1月-2015年6月确诊的200例反复上呼吸道感染患儿为研究组,选择同期健康体检正常儿童100例为对照组,通过原子吸收光谱仪测定两组血清相关微量元素(锌、铁)和常量元素(镁),并比较反复上呼吸道感染不同发作频率、不同病情患儿血清锌、铁水平;另给予患儿间断补锌、铁治疗,治疗3个月,随访1年观察临床疗效,比较治疗前、后血清微量和常量元素、免疫功能相关指标变化。结果研究组血清锌、铁水平分别为(73.03±16.24)μmol/L、(7.89±0.87)mmol/L,均显著低于对照组的(90.26±18.47)μmol/L、(9.53±0.65)mmol/L,差异有统计学意义(P<0.05);研究组血清镁水平(1.57±0.50)mmol/L与对照组(1.63±0.42)mmol/L比较,差异无统计学意义(P>0.05);不同发作频率、不同病情反复上呼吸道感染患儿血清、锌、铁水平比较差异有统计学意义(P<0.05);间断补锌、铁治疗后随访1年总有效率高达98.00%;治疗3个月后血清锌、铁、IgA、IgG、CD~+_4、CD~+_4/CD~+_8较治疗前均显著上升,差异有统计学意义(P<0.05)。结论反复上呼吸道感染患儿血清锌、铁水平明显偏低,且与发作频率、病情严重程度密切相关;间断补锌、铁等微量元素能明显改善患儿免疫功能,防治反复上呼吸道感染效果良好。
Objective To analyze the serum trace elements (zinc, iron) and the elemental (magnesium) deficiency in children with recurrent upper respiratory tract infection and to observe the effect of intermittent zinc and iron prevention and treatment. Methods A total of 200 children with recurrent upper respiratory tract infection diagnosed in our hospital from January 2014 to June 2015 were enrolled in this study. 100 healthy children in the same period were selected as the control group. Serum levels of trace elements (Zinc, iron) and constant elements (magnesium), and compared serum zinc and iron levels in children with different seizure frequency and different recurrent upper respiratory tract infections. The patients were treated with intermittent zinc supplementation and iron therapy for 3 months, followed up for 1 month The clinical efficacy was observed in years. The levels of serum trace elements and macrophages before and after treatment were compared, and the changes of immune function related indexes were compared. Results The levels of serum zinc and iron in the study group were (73.03 ± 16.24) μmol / L and (7.89 ± 0.87) mmol / L, respectively, which were significantly lower than those in the control group (90.26 ± 18.47μmol / L, 9.53 ± 0.65mmol / (P <0.05). There was no significant difference in the level of serum magnesium (1.57 ± 0.50) mmol / L and the control group (1.63 ± 0.42) mmol / L in the study group (P> 0.05) (P <0.05). The total effective rate of intermittent zinc supplementation and follow-up of 1 year after iron treatment was 98.00%. Treatment 3 showed no significant difference between the two groups The levels of serum zinc, iron, IgA, IgG, CD ~ + _4, CD ~ + _4 / CD ~ + _8 in the serum of all patients were significantly higher than those before treatment (P <0.05). Conclusions Serum levels of zinc and iron in patients with recurrent upper respiratory tract infection were significantly lower than those in patients with recurrent respiratory tract infections, and were closely related to the frequency of seizures and the severity of the disease. Intermittent zinc, iron and other trace elements could significantly improve children’s immune function and prevent recurrent upper respiratory tract infection .