标题：血清25-羟基维生素D水平与儿童过敏性鼻炎病情严重程度的关系

      作者：高楠，刘羡伟，张永岗，高娟，安良    西安高新医院检验科，陕西 西安 710010

      卷次： 2022年33卷19期

      【摘要】 目的 分析血清25-羟基维生素D [25(OH)D]水平与儿童过敏性鼻炎(AR)病情严重程度的关系，为儿童AR的防治提供参考依据。方法 选取2020年10月至2021年6月西安高新医院收治的100例AR患儿为研究对象，按照《儿童过敏性鼻炎诊疗-临床实践指南》分为中重度AR组45例和轻度AR组55例，以同期50例健康体检儿童作为对照组；对AR患儿进行过敏性鼻炎评分量表(SFAR)评分及症状视觉模拟量表(VAS)评分，检测三组受检者的血清25(OH)D及特异性免疫球蛋白E (IgE)水平；采用Spearman相关性分析血清25(OH)D、特异性 IgE水平、SFAR评分、症状VAS评分之间的关系，采用受试者工作特征曲线(ROC)分析血清25(OH)D水平对中重度儿童AR的诊断效能。结果 中重度AR组与轻度AR组患儿的血清25(OH)D水平分别为(9.65±1.27) ng/mL、(15.70±3.18) ng/mL，明显低于对照组的(26.49±6.35) ng/mL，血清特异性 IgE水平分别为(7.22±1.04) kU/L、(3.58±0.62) kU/L，明显高于对照组的(0.21±0.05) kU/L，而中重度AR组患儿的血清25(OH)D水平明显低于轻度AR组，血清特异性 IgE水平明显高于轻度AR组，差异均有统计学意义(P<0.05)；中重度AR组和轻度AR组患儿的SFAR评分[(10.25±1.13)分 vs (6.27±2.33)分]和症状VAS评分[(8.96±0.58)分 vs (5.59±2.20)分]比较，中重度AR组明显高于轻度AR组，差异均有统计学意义(P<0.05)；经 Spearman相关性分析结果显示，血清 25(OH)D水平与血清特异性 IgE水平(r=-0.638，P<0.05)、SFAR评分(r=-0.726，P<0.05)、症状VAS评分(r=-0.685，P<0.05)均呈明显负相关，血清特异性 IgE水平与SFAR评分(r=0.710，P<0.05)、症状VAS评分(r=0.693，P<0.05)均呈明显正相关；血清25(OH)D水平诊断中重度儿童AR的曲线下面积(AUC)为 0.875，最佳临界值为 10.26 ng/mL，敏感性为 89.50%，特异性为 80.42%。结论 血清 25(OH)D水平与儿童AR病情严重程度负相关，可用于AR的辅助诊断。
      【关键词】 儿童；过敏性鼻炎；25-羟基维生素D；特异性免疫球蛋白E；过敏性鼻炎评分量表；症状视觉模拟量表；相关性
      【中图分类号】 R729 【文献标识码】 A 【文章编号】 1003—6350（2022）19—2526—04

Relationship between serum levels of 25-hydroxyvitamin D and severity of allergic rhinitis in children.
GAO Nan,LIU Xian-wei, ZHANG Yong-gang, GAO Juan, AN Liang. Department of Clinical Laboratory, Xi'an Gaoxin Hospital, Xi’an710010, Shaanxi, CHINA
【Abstract】 Objective To discuss the relationship between serum levels of 25-hydroxyvitamin D [25(OH)D]and severity of allergic rhinitis (AR) in children. Methods A total of 100 AR children who were treated in Xi'an Gaox-in Hospital from October 2020 to June 2021 were selected as the research subjects. The children were divided into mod-erate-severe AR group (45 cases) and mild AR group (55 cases) according to the Guidelines for the Diagnosis and Treat-ment of Allergic Rhinitis in Children-Clinical Practice. Fifty healthy children undergoing physical examination in thehospital during the same time period were taken as the control group. The Scale for Anaphylactic Rhinitis (SFAR) and Vi-sual Analogue Scale (VAS) were used to evaluate the AR children. The serum levels of 25(OH)D and specific immuno-globulin E (IgE) were detected in the three groups. Spearman correlation was used to analyze the relationship among se-rum levels of 25(OH)D, specific IgE, SFAR score, VAS score. Receiver operating characteristic curve (ROC) curve wasused to analyze the diagnostic efficacy of serum levels of 25(OH)D in moderate-severe AR children. Results The se-rum levels of 25(OH)D was (9.65 ± 1.27) ng/mL in moderate-severe AR group and (15.70 ± 3.18) ng/mL in mild ARgroup, both significantly lower than (26.49±6.35) ng/mL in the control group; the serum level in moderate-severe ARgroup was significantly lower than that in mild AR group; the differences were statistically significant (P<0.05). The lev-els of specific IgE was (7.22±1.04) kU/L in moderate-severe AR group and (3.58±0.62) kU/L in mild AR group, both sig-nificantly higher than (0.21±0.05) kU/L in the control group; the level in moderate-severe AR group was significantly high-er than that in mild AR group; the differences were statistically significant (P<0.05). The SFAR score and VAS score were(10.25±1.13) points and (8.96±0.58) points in moderate-severe AR group, significantly higher than (6.27±2.33) points and(5.59±2.20) points in mild AR group (P<0.05). Spearman correlation analysis showed that serum levels of 25(OH)D wasnegatively correlated with serum levels of specific IgE (r=-0.638, P<0.001), SFAR score (r=-0.726, P<0.001), and VASscore (r=-0.685, P<0.001). The serum levels of specific IgE was positively correlated with SFAR score (r=0.710, P<0.001) and VAS score (r=0.693, P<0.001). The AUC of serum levels of 25(OH)D for the diagnosis of moderate-severeAR children was 0.875, and the best critical value, sensitivity, specificity were 10.26 ng/mL, 89.50%, 80.42%, respective-