维生素A、D含量与儿童肺炎支原体肺炎病情程度及临床转归的关系探究  

Exploring the Relationship Between Vitamin A and D Levels and the Severity and Clinical Outcome of Mycoplasma Pneumoniae Pneumonia in Children

作　　者：封其华[1] 李锦芬[2] FENG Qihua;LI Jinfen(Department of Pediatrics,Children’s Hospital Affiliated to Soochow University,Suzhou 215003,China;Department of Pediatrics,Dushu Lake Hospital Affiliated to Soochow University,Suzhou 215000,Jiangsu,China)

机构地区：[1]苏州大学附属儿童医院儿科,江苏苏州215003 [2]苏州大学附属独墅湖医院儿科,江苏苏州215000

出　　处：《标记免疫分析与临床》2024年第9期1641-1647,1710,共8页Labeled Immunoassays and Clinical Medicine

基　　金：苏州市科技发展计划医疗器械与新医药(临床试验)项目(编号:SLT201936)。

摘　　要：目的研究维生素A、D含量与儿童肺炎支原体肺炎病情程度及临床转归的关系。方法选取2022年1月至2023年6月期间于我院(苏州大学附属儿童医院)就诊的肺炎支原体肺炎患儿92例作为研究组,以同期于我院体检的性别、年龄匹配的92例健康儿童作为对照组,检测血清维生素A、D含量,分析维生素A、D在健康组与研究组血清中含量及与肺炎支原体肺炎患儿病情的关系。根据肺炎支原体肺炎患儿临床转归情况分为转归优良组(n=66)、转归不良组(n=26)两组,比较维生素A、D含量,明确影响患儿临床转归的因素,分析维生素A、D含量对肺炎支原体肺炎患儿疾病程度、临床转归的预测价值。结果与对照组比较,研究组维生素A、D含量降低,维生素A、D缺乏率升高(P<0.05)。与轻症患儿比较,重症肺炎支原体肺炎患儿维生素A、D含量降低,维生素A、D缺乏率升高(P<0.05)。与转归优良组比较,转归不良组患儿年龄较低,热程≥7d、重症、心肌酶谱异常、有胸腔积液、有肺外并发症比例、实验室指标CRP、D-D、LDH水平升高(P<0.05)。与治疗前比较,转归不良组、转归优良组治疗后血清维生素A、D含量均有所升高(P<0.05),维生素A、D缺乏率均降低,但比较差异无统计学意义(P>0.05);转归不良组肺炎支原体肺炎患儿治疗前后血清维生素A、D含量均低于转归优良组,治疗前后维生素A、D缺乏率高于转归优良组(P<0.05)。肺炎支原体肺炎患儿临床转归不良受热程病情程度、胸腔积液、肺外并发症、实验室指标、维生素A、维生素D等多个因素的影响(P<0.05)。经绘制ROC曲线发现,治疗前维生素A、D两项联合诊断肺炎支原体肺炎患儿病情程度的效能优于单项(P<0.05)。经绘制ROC曲线发现,单独预测时,治疗后维生素D预测效能优于治疗后维生素A、优于治疗前维生素D、优于治疗前维生素A;联合诊断时,治疗前维生素A、D、治疗后Objective To investigate the relationship between vitamin A and D levels and the severity and clinical outcome of Mycoplasma Pneumoniae pneumonia in children.Methods We selected 92 cases of children with Mycoplasma Pneumoniae pneumonia from January,2022 to June,2023 in our hospital as a research group.During the same period,92 cases of healthy children from physical examination,matching with sex and age,were selected as the control group.We tested serum vitamin A,D content,and investigated their relationship with Mycoplasma Pneumoniae pneumonia children.According to the clinical outcome of children with Mycoplasma Pneumoniae pneumonia,the subjects were divided into two groups:an excellent outcome(n=66)and a poor group(n=26).The contents of vitamin A and D were compared,the factors affecting the clinical outcome of children were defined,and the predictive value of vitamin A and D content on the disease degree and clinical outcome of children with Mycoplasma Pneumoniae pneumonia were analyzed.Results Compared with the control group,vitamin A and D content in the study group decreased,while vitamin A and D deficiency rate increased(P<0.05).Compared with children with mild disease,children with severe Mycoplasma Pneumoniae had decreased vitamin A and D content,while the rate of vitamin A and D deficiency increased(P<0.05).Compared with the excellent outcome group,the poor group was younger,with 7d,severe illness,abnormal myocardial enzyme spectrum,pleural effusion,extrapulmonary complications,and increased laboratory indicators of CRP,D-D,and LDH levels(P<0.05).Compared with before treatment,levels of serum vitamin A and D increased in both the poor and excellent conversion groups after treatment(P<0.05),and the deficiency rates of vitamin A and D decreased,but the difference was not statistically significant(P>0.05);Serum vitamin A and D levels in children with Mycoplasma Pneumoniae pneumonia in the poor conversion group were lower than those in the excellent conversion group before and after treatment,while the vit

关 键 词：维生素A 维生素D 儿童肺炎支原体肺炎 病情程度 临床转归 

分 类 号：Q56[生物学—生物化学]