标题:血清25羟维生素D、免疫球蛋白水平与小儿支气管肺炎严重程度及转归的关系研究
作者:朱云芳,彭林强,薛满,马春利,刘亚辉,梁宽 宝鸡市人民医院儿科,陕西 宝鸡 721000
卷次:
2022年33卷20期
【摘要】 目的 探讨血清25羟维生素D [25-(OH)D3]、免疫球蛋白(Ig)水平与小儿支气管肺炎严重程度及转归的关系。方法 选取宝鸡市人民医院2018年1月至2021年1月收治的103例支气管肺炎患儿作为研究组,根据病情严重程度分为轻症组(n=65)和重症组(n=38),根据治疗1个疗程后转归情况分为转归良好组(n=80)和转归不良组(n=23),另选取同期健康体检儿童70例作为对照组,检测并比较所有受试者的血清25-(OH)D3、IgE、IgM、IgA水平,采用Spearman相关性分析血清25-(OH)D3、IgE、IgM、IgA水平与病情严重程度的关系,采用受试者工作特征曲线(ROC)分析血清25-(OH)D3、IgE、IgM、IgA水平对转归的评估价值。结果 研究组患儿的血清25-(OH)D3、IgA水平分别为(21.57±3.67) nmol/L、(1.09±0.21) g/L,明显低于对照组的(30.25±4.39) nmol/L、(1.41±0.28) g/L,差异均有统计学意义(P<0.05);研究组患儿的血清 IgE、IgM水平分别为(65.69±7.45) g/L、(1.74±0.42)g/L,明显高于对照组的(19.85±2.64) g/L、(0.97±0.16) g/L,差异均有统计学意义(P<0.05);治疗前,重症组患儿的血清25-(OH)D3、IgA水平分别为(17.36±1.51) nmol/L、(0.85±0.13) g/L,明显低于轻症组的(24.03±2.39) nmol/L、(1.23±0.22) g/L,差异均有统计学意义(P<0.05);治疗前,重症组患儿的血清 IgE、IgM水平分别为(77.66±3.15) g/L、(2.13±0.26) g/L,明显高于轻症组的(58.69±3.84) g/L、(1.51±0.19) g/L,差异均有统计学意义(P<0.05);治疗后,重症组患儿的血清 25-(OH)D3、IgA水平分别为(26.03±2.95) nmol/L、(1.23±0.17) g/L,明显低于轻症组的(29.38±4.01) nmol/L、(1.39±0.21) g/L,差异均有统计学意义(P<0.05);治疗后,重症组血清 IgE、IgM水平分别为(26.07±4.59) g/L、(1.28±0.29) g/L,明显高于轻症组的 (20.24±3.05) g/L、(1.04±0.13) g/L,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)D3、IgA水平与支气管肺炎患儿病情严重程度呈负相关(r=-0.631、-0.574,P<0.05),IgE、IgM与病情严重程度呈正相关(r=0.726、0.668,P<0.05);转归不良组患儿的血清 25-(OH)D3、IgA水平分别为(19.12±2.01) nmol/L、(0.98±0.13) g/L,明显低于转归良好组的(22.27±2.24) nmol/L、(1.12±0.19) g/L,差异均有统计学意义(P<0.05);转归不良组患儿的血清 IgE、IgM水平分别为(74.42±4.21) g/L、(1.97±0.34) g/L,明显高于转归良好组的(63.18±3.53) g/L、(1.67±0.25) g/L,差异均有统计学意义(P<0.05);经ROC分析结果显示,血清25-(OH)D3、IgE、IgM、IgA联合评估支气管肺炎患儿转归情况的曲线下面积(AUC)为0.871,高于四者单独评估的0.749、0.744、0.713、0.735。结论 支气管肺炎患儿血清25-(OH)D3、IgA水平降低,IgE、IgM水平升高,四者与疾病严重程度具有相关性,联合检测对评估患儿转归情况具有指导作用。
【关键词】 儿童;支气管肺炎;25羟维生素D;免疫球蛋白;疾病严重程度;转归
【中图分类号】 R725.6 【文献标识码】 A 【文章编号】 1003—6350(2022)20—2661—04
Relationship between serum 25-hydroxyvitamin D, immunoglobulins and disease severity, outcomes in childrenwith bronchial pneumonia.
ZHU Yun-fang, PENG Lin-qiang, XUE Man, MA Chun-li, LIU Ya-hui, LIANG Kuan.Department of Pediatrics, Baoji People's Hospital, Baoji 721000, Shaanxi, CHINA
【Abstract】 Objective To explore the relationship between serum 25-hydroxyvitamin D [25-(OH)D3], immu-noglobulin (Ig) and disease severity, outcome of children with bronchial pneumonia. Methods A total of 103 childrenwith bronchial pneumonia admitted to Baoji People's Hospital were enrolled as study group between January 2018 andJanuary 2021. According to disease severity, they were divided into mild group (n=65) and severe group (n=38). Accord-ing to outcomes after one course of treatment, they were divided into good outcome group (n=80) and poor outcomegroup (n=23). A total of 70 healthy children undergoing physical examination during the same period were enrolled ascontrol group. The levels of serum 25-(OH)D3, IgE, IgM, and IgA in all subjects were compared. Their relationship withdisease severity was analyzed by Spearman correlation analysis, and their evaluation value for outcomes was analyzedby receiver operating characteristic (ROC) curves. Results The levels of serum 25-(OH)D3 and IgA in the study groupwere (21.57±3.67) nmol/L and (1.09±0.21) g/L, significantly lower than (30.25±4.39) nmol/L and (1.41±0.28) g/L in thecontrol group (P<0.05). The levels of serum IgE and IgM in the study group were (65.69±7.45) g/L and (1.74±0.42) g/L,
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