不同病原体感染所致重症肺炎患儿的维生素A、D水平变化及其临床意义  

Variations in vitamin A and D levels and their clinical significance in children with severe pneumonia resulting from various pathogens-caused infection

作　　者：陈芬[1] 马悦[1] 姚彤[1] 罗新辉[1] CHEN Fen;MA Yue;YAO Tong;LUO Xin-hui(Department of Pediatrics,the People′s Hospital of Xinjiang Uygur Autonomous Region,Urumqi 830001,China)

机构地区：[1]新疆维吾尔自治区人民医院儿科,乌鲁木齐市830001

出　　处：《广西医学》2020年第23期3023-3029,共7页Guangxi Medical Journal

基　　金：国家卫生计生委医药卫生科技发展项目(W2016EWQT24)。

摘　　要：目的探讨不同病原体感染所致重症肺炎患儿的维生素A、D水平变化及其在病因鉴别中的作用,以及补充维生素A和维生素D对疗效的改善作用。方法(1)根据咽拭子或痰液病原学检测结果,将133例重症肺炎患儿分为细菌感染组40例、支原体感染组39例、病毒感染组54例,另取健康儿童42例为正常对照组。比较正常对照组与3组重症肺炎患儿治疗前的维生素A、D水平、不足发生率、缺乏发生率。(2)分别将细菌感染组、支原体感染组、病毒感染组随机分为常规治疗亚组和补充治疗亚组。所有患儿均给予抗感染及其他常规治疗,补充治疗组同时给予维生素A和维生素D补充治疗。比较常规治疗亚组和补充治疗亚组治疗前后的维生素A、维生素D、IgA、CD4+T淋巴细胞、CD8+T淋巴细胞水平和CD4+/CD8+比值,以及肺炎的治疗总有效率。结果(1)治疗前,与正常对照组相比,3组重症肺炎患儿的维生素A和维生素D水平均下降,且病毒感染组、细菌感染组、支原体感染组的维生素A水平依次下降;3组重症肺炎患儿治疗前的维生素A和维生素D不足发生率均升高,细菌感染组和支原体感染组的维生素A缺乏发生率、支原体感染组的维生素D缺乏发生率均升高,且支原体感染组的维生素A缺乏发生率较病毒感染组高(均P<0.05)。(2)补充治疗-细菌感染亚组患儿治疗后的维生素D及IgA水平均高于治疗前及常规治疗-细菌感染亚组,而CD8+T淋巴细胞水平低于治疗前水平及常规治疗-细菌感染亚组(均P<0.05);补充治疗-支原体感染亚组治疗后的维生素A、维生素D、IgA、CD4+T淋巴细胞水平及CD4+/CD8+比值均高于治疗前及常规治疗-支原体感染亚组,而CD8+T淋巴细胞水平低于治疗前及常规治疗-支原体感染亚组(均P<0.05)。各常规治疗亚组和对应的补充治疗亚组的肺炎的治疗总有效率差异均无统计学意义(均P>0.05)。结论不同病原体感�Objective To investigate the variations in vitamin A and D levels and their roles in etiological differentiation,as well as the improvement effect of vitamin A and D supplements on efficacy,in children with severe pneumonia resulting from various pathogens-caused infection.Methods(1)Totally 133 children with severe pneumonia were divided into bacterial infection group(n=40),Mycoplasma infection group(n=39)and virus infection group(n=54)based on the results of throat swab testing or sputum etiological detection,and another 42 healthy children were enrolled as normal control group.The levels of vitamin A and D as well as the incidence rates of vitamin A or D insufficiency and deficiency were compared between the normal control group and the three groups of severe pneumonia children before treatment.(2)The bacterial infection group,the Mycoplasma infection group and the virus infection group were randomly subgrouped into routine therapy group and supplementary therapy group separately.All the children received anti-infection therapy and other routine therapy,and the supplementary therapy groups were also treated with vitamin A and D complementally.The following indexes were compared between the routine therapy and supplementary therapy groups:vitamin A and D levels,IgA level,CD4+T lymphocyte level,CD8+T lymphocyte level and CD4+/CD8+ratio before and after treatment,as well as the total effective rate for pneumonia treatment.Results(1)Before treatment,the three groups of severe pneumonia children exhibited decreased levels of vitamin A and D as compared with the normal control group,in addition,vitamin A level decreased in the virus infection group,the bacterial infection group and the Mycoplasma infection group successively;the three groups of severe pneumonia children possessed elevated incidence rates of pre-therapy vitamin A and D insufficiency,the bacterial infection group or the Mycoplasma infection group exhibited a higher incidence rate of vitamin A deficiency,the Mycoplasma infection group had a higher incid

关 键 词：重症肺炎 儿童 维生素A 维生素D 病原学 肺炎支原体 细菌 病毒 补充治疗 免疫功能 疗效 

分 类 号：R725.6[医药卫生—儿科]