传染性单核细胞增多症儿童的维生素D水平与肝功能的相关性研究  

Study of the correlation between vitamin D level and liver function in children with infectious mononucleosis

作　　者：张玉凤 何一秀 赵少杰 潘梦澜 陈炳章 朱亚非[1] Zhang Yufeng;He Yixiu;Zhao Shaojie;Pan Menglan;Chen Bingzhang;Zhu Yafei(Department of Pediatrics,the Affiliated Hospital of Hangzhou Normal University,Hangzhou 310000,China)

机构地区：[1]杭州师范大学附属医院儿科,杭州310000

出　　处：《新医学》2023年第9期655-659,共5页Journal of New Medicine

基　　金：杭州市科技计划项目(20191203B107)。

摘　　要：目的探讨血清25-羟维生素D[25(OH)D]在儿童传染性单核细胞增多症(IM)中的水平及与肝功能的相关性。方法选取90例急性期IM患儿作为IM组,同期同地点体检的40例健康儿童作为对照组。用电化学发光法检测2组的血清25(OH)D水平,并用实时荧光定量PCR技术测定血浆EB病毒DNA(EBV-DNA)载量。比较2组的临床资料及血清25(OH)D水平;并将IM组25(OH)D水平与异型淋巴细胞、肝功能指标及血浆EBVDNA等指标进行相关分析。结果IM组血清25(OH)D水平低于对照组,25(OH)D不充足率高于对照组(P均<0.05)。IM组血清25(OH)D水平与异型淋巴细胞呈负相关(P<0.05)。IM组中维生素D不充足亚组的ALT、AST、谷酰转肽酶(GGT)和腺苷脱氨酶(ADA)水平均高于维生素D充足亚组,胆碱酯酶(CHE)的水平则相对低(P均<0.05);充足亚组与不充足亚组总胆红素、直接胆红素及血浆EBV-DNA载量比较差异无统计学意义(P均<0.05)。IM组血清25(OH)D水平与ALT、GGT及ADA均呈负相关,与CHE呈正相关(P均<0.05),与AST、总胆红素、直接胆红素均无相关性(P均<0.05)。结论IM患儿存在血清维生素D缺乏的情况,维生素D可能参与IM患儿病程的发生发展并与肝功能损害相关。Objective To investigate the correlation between the serum level of 25-hydroxyvitamin D(25(OH)D)and liver function in children with infectious mononucleosis(IM).Methods Ninety children with acute IM were enrolled into the IM group,and 40 healthy children who underwent physical examination during the same period were allocated into the control group.Serum level of 25(OH)D was determined by electrochemiluminescence and the viral load of Epstein-Barr virus DNA(EBVDNA)in plasma was determined by quantitative fluorescent RT-PCR.Clinical data and serum 25(OH)D levels were compared between two groups.The correlation between 25(OH)D level and atypical lymphocytes,liver function parameters and plasma EBVDNA in children with IM was analyzed.Results Serum 25(OH)D level in the IM group was significantly lower,whereas the 25(OH)D inadequacy rate was significantly higher than those in the control group(both P<0.05).Serum 25(OH)D level was negatively correlated with atypical lymphocytes in the IM group(P<0.05).The levels of alanine aminotransferase(ALT),aspartate aminotransferase(AST),glutamyl transpeptidase(GGT),and adenosine deaminase(ADA)in IM children with serum 25(OH)D inadequacy were higher than those in their counterparts with adequate serum 25(OH)D(all P<0.05).No significant differences were found in total bilirubin(TBIL),direct bilirubin(DBIL)and plasma EBV-DNA load between the adequate and inadequate subgroups(all P>0.05).In the IM group,serum 25(OH)D level was negatively correlated with ALT,GGT,and ADA(all P<0.05),whereas positively correlated with CHE(P<0.05)and had no correlation with AST,TBIL or DBIL(all P>0.05).Conclusions Serum vitamin D insufficiency occurs in children with IM.Vitamin D may be involved in the incidence and development of the course of IM,which is probably associated with liver function impairment.

关 键 词：儿童 EB病毒 25-羟维生素D 肝功能 

分 类 号：R725.1[医药卫生—儿科]