川崎病患儿25-羟基维生素D3水平变化及意义

Changes in 25-hydroxyvitamin D3 level and its significance in children with Kawasaki disease

摘要:

目的 研究川崎病(KD)患儿血清25-羟基维生素D₃[25-(OH)D₃] 水平的变化及意义。方法 收集2012 年1 月至2015 年8 月242 例KD 患儿的临床资料,根据有无冠状动脉损伤(CAL)分为CAL组(63 例)和非CAL 组(NCAL,179 例),并且按照IVIG 治疗效果分为IVIG 敏感组(219 例)和IVIG 无反应组(23 例)。选择同期40 例健康儿童(对照组)和急性上呼吸道感染患儿40 例(上感组)为对照,通过酶联免疫法检测各组血清25-(OH)D₃ 水平。结果 IVIG 治疗前:上感组、NCAL 组和CAL 组25-(OH)D₃ 水平低于对照组(P<0.05),以CAL 组最低(P<0.05);上感组、IVIG 敏感组和IVIG 无反应组25-(OH)D₃ 水平均低于对照组(P<0.05),以IVIG 无反应组最低(P<0.05)。IVIG 治疗后:CAL 组的25-(OH)D₃ 水平低于NCAL 组及对照组(P<0.05);IVIG 无反应组的25-(OH)D₃ 水平低于IVIG 敏感组及对照组(P<0.05),以IVIG 无反应组最低(P<0.05)。结论 KD 患儿25-(OH)D₃ 水平下降,而且降低越明显,出现CAL 以及无反应型KD 的可能性越大。

Abstract:

Objective To investigate the changes in the serum level of 25-hydroxyvitamin D₃ [25-(OH)D₃] and its significance in children with Kawasaki disease (KD). Methods The clinical data of 242 KD children were collected. According to the presence or absence of coronary artery lesion (CAL), these children were classified into CAL group (63 children) and non-CAL (NCAL) group (179 children). According to the efficacy of intravenous immunoglobulin (IVIG), these children were classified into IVIG-sensitive group (219 children) and no-IVIG-response group (23 children). A total of 40 healthy children (control group) and 40 children with acute upper respiratory tract infection (AURI group) were enrolled as controls. Enzyme-linked immunosorbent assay was applied to measure the serum level of 25-(OH)D₃. Results Before IVIG treatment, the AURI, NCAL, and CAL groups had significantly lower serum levels of 25-(OH)D₃ than the control group (P<0.05); the CAL group had a significantly lower serum level of 25-(OH)D₃ than the AURI and NCAL groups (P<0.05); the AURI, IVIG-sensitive, and no-IVIG-response groups had significantly lower serum levels of 25-(OH)D₃ than the control group (P<0.05); the no-IVIG-response group had a significantly lower serum level of 25-(OH)D₃ than the AURI and IVIG-sensitive groups (P<0.05). After IVIG treatment, the CAL group had a significantly lower serum level of 25-(OH)D₃ than the NCAL and control groups (P<0.05); the no-IVIG-response group had a significantly lower serum level of 25-(OH)D₃ than the IVIG-sensitive and control groups (P<0.05). Conclusions KD children may experience a reduction in the serum level of 25-(OH)D₃. With a greater reduction in the serum level of 25-(OH)D₃, the possibility of CAL and KD with no response to treatment increases.