3 岁以内肺炎患儿血清维生素A水平研究

Serum level of vitamin A in children with pneumonia aged less than 3 years

摘要:

目的 探讨肺炎患儿维生素A（VA）水平与肺炎严重程度及反复呼吸道感染（RRI）的关系，为VA 水平作为肺炎病情判断及反复呼吸道感染风险预测提供理论基础。方法 选取88 例3 岁以下的肺炎患儿为研究对象，检测入院时血清VA 水平，并随访出院后1 年的RRI 发生情况。结果 88 例肺炎患儿的血清VA 水平为0.8±0.3 μmol/L，其中维生素A 缺乏（VAD）的35 例（40%，35/88）。重症肺炎组血清VA 水平低于轻症肺炎组（0.7±0.3 μmol/L vs 0.9±0.3 μmol/L），P < 0.05；VAD 检出率高于轻症肺炎组（63% vs 28%），P < 0.05。随访1 年， VAD 肺炎组的RRI 发生率高于VA 正常组（49% vs 18%），P < 0.05；但可疑亚临床维生素A 缺乏（SSVAD）肺炎组与VA 正常肺炎组、VAD 肺炎组与SSVAD 肺炎组之间的RRI 发生率差异无统计学意义（P>0.05）。结论 肺炎患儿VA 水平高低与病情严重程度及反复呼吸道感染的发生相关。

Abstract:

Objective To investigate the association of the serum level of vitamin A (VA) with the severity of pneumonia and recurrent respiratory infection (RRI) within one year after treatment in children with pneumonia, and to provide a basis for serum VA level used as an index for judgment of the condition of pneumonia and prediction of the risk of recurrent respiratory infection. Methods A total of 88 children with pneumonia aged less than 3 years were enrolled as study subjects. Serum VA level was measured on admission, and the development of RRI was followed up by telephone within 1 year after discharge. Results The children with pneumonia showed a reduction in the serum level of VA (0.8±0.3 μmol/L). The severe pneumonia group had a significantly lower serum level of VA than the mild pneumonia group (0.7±0.3 μmol/L vs 0.9±0.3 μmol/L; P < 0.05), as well as a significantly higher detection rate of vitamin A deficiency (VAD) than the mild pneumonia group (63% vs 28%; P < 0.05). The children were followed up for 1 year. The VAD-pneumonia group showed a significantly higher incidence of RRI than the normal VA-pneumonia group (49% vs 18%; P < 0.05), while there were no significant differences in the incidence of RRI between the suspected subclinical vitamin A deficiency (SSVAD) -pneumonia group and the normal VA-pneumonia group, as well as between the VADpneumonia group and the SSVAD-pneumonia group (P>0.05). Conclusions Children with pneumonia often have a low level of VA, and the level of VA is associated with the severity of pneumonia and the development of RRI afterwards.