维生素A与儿童呼吸道感染关系的研究进展北大核心CSCD

维生素A是机体生长发育必需的营养素,在维持视觉功能、促进上皮细胞增殖分化、增强机体免疫应答等方面发挥重要作用。儿童免疫系统发育不成熟,尤其是体液免疫功能处于早期阶段,极易患呼吸道感染。研究显示机体维生素A水平与儿童反复呼吸道感染关系密切。本文通过查阅大量文献,主要从维生素A影响机体免疫系统的作用机制及对呼吸系统的免疫调控两方面对维生素A与儿童呼吸道感染的关系进行综述,为儿童呼吸道感染防治提供支撑。     

维生素A与免疫

近些年来，越来越多的实验资料证实维生素Ａ与机体免疫功能的关系密切。维生素Ａ缺乏能从多方面影响免疫系统的功能，使淋巴器官萎缩、ＮＫ细胞活性降低、细胞免疫反应下降。更重要的是，维生素Ａ缺乏使机体对细菌、病毒、寄生虫等抗原成分产生的特异性抗体明显减少。维生素Ａ正常水平的动物，给予维生素Ａ，可以发挥佐剂作用，提高机体对特异抗原的抗体应答，并能增强细胞免疫，产生抗肿瘤作用。     

母孕期维生素A缺乏与出生缺陷的研究进展

维生素A是人体必需的营养素之一,在机体生长发育方面发挥重要作用.母孕期维生素A的缺乏严重影响胚胎生长发育,导致心脏、支气管、眼、中枢神经系统、肢体等出生缺陷.维生素A主要通过调控目的基因,参与胚胎生长发育.因此,研究孕母维生素A缺乏对胎儿的影响,可有利于积极防治严重的出生缺陷.

Abstract：

Vitamin A is one of the essential nutrients, and it plays an important role in growth and development. The lack of vitamin A during pregnancy seriously affect embryonic development, leading to some birth defects of heart, bronchiole, eye, central nervous system, limbs, and others. It is primarily through the regulation of target genes involved in embryonic growth and development. Therefore, study on and understanding of the lack of maternal vitamin A can help prevent and treat serious birth defects.     

维生素D在儿童呼吸系统疾病中的研究进展

维生素D是人体不可缺少的营养素之一,具有广泛的生物学效应.维生素D不仅调节钙磷代谢,促进骨骼钙化,还作为重要的免疫调节因子在固有免疫应答和适应性免疫应答中发挥着重要作用,与呼吸系统疾病发生、发展密切相关.近年研究表明,维生素D缺乏可使免疫细胞增殖和分化偏移而产生异常免疫反应,增加呼吸系统疾病易感性和严重程度.儿童是维生素D缺乏的高危人群,深入研究维生素D的免疫调节功能,将为治疗儿童呼吸系统疾病提供理论基础.     

大庆地区儿童维生素A与铁营养状况的相关性研究

目的了解大庆市儿童维生素A（VA）和铁营养状况之间的关系。方法对大庆市400名3～12岁儿童血浆VA和铁营养状况进行评价,并对其相关性进行分析。结果受试儿童VA平均含量为（1.03±0.20）μmol/L,其中7.8%患VA缺乏,40.5%儿童VA边缘缺乏。血浆VA与Hb呈正相关（r=0.13226,P〈0.05）,与sTfR呈负相关（r=-0.12681,P〈0.05）,与TIBC、SF不相关。结论铁缺乏伴随VA边缘缺乏在我市儿童中普遍存在,VA与铁营养状况存在相关性。     

郑州地区1180例儿童维生素A、D、E水平研究

目的 了解郑州地区儿童维生素的水平,为临床诊治提供参考.方法 以2016年3月至12月期间在郑州大学第三附属医院儿科门诊健康体检的儿童为研究对象,测量血清25羟维生素D[25(OH)D]、维生素A、E的水平.结果 1180名儿童中,男童755例,女童425例,维生素A平均水平0.22±0.07 mg/L,总体缺乏率为45.34％;维生素D平均水平为64.25±19.65 nmol/L,总体缺乏率为30.51％;维生素E平均水平为4.95±1.64 mg/L,总体缺乏率为51.10％.男童和女童血清维生素E水平差异具有统计学意义(P＜0.05);郑州市城乡儿童三种血清维生素水平差异均具有统计学意义(P＜0.05).结论 儿童维生素的水平缺乏情况,应引起我们的重视,尤其是维生素E,城乡儿童仍然需要进行及时的维生素补充,以预防儿童维生素缺乏症及其并发症的发生.     

维生素A、D缺乏和预防治疗

1 维生素A缺乏 1.1 症状、体征 维生素A缺乏首先累及眼睛(干眼病),主要是幼儿.随之干燥症及球结膜干燥症,常见于颞侧的睑间裂.     

母体维生素D缺乏与小儿佝偻病

1919年Mellanby教授首先发现:由于营养障碍可导致一种骨的疾病,他将此病态命名为佝偻病。1922年McCollum教授发现了雪鱼肝油中存在一种抗佝偻病因子,并且命名此因子为维生素D。1936年Winduas教授确定了维生素D的化学结构,并发现对人体进行紫外线照射能预防佝偻病。这种曾经是原因不明、多发性疾患的难治病,随人们日光浴的增加及强化维生     

血清25-羟维生素D水平对儿童免疫功能的影响

目的探讨25-（OH）VitD水平与儿童免疫功能之间的关系。方法随机选取山西省妇幼保健院门诊进行健康体检的3～8岁儿童117名,采用酶联免疫法检测25-（OH）VitD水平,流式细胞术检测细胞免疫功能。按照血清25-（OH）VitD浓度将病例分为两组：维生素D缺乏组（〈50nmol／L）及维生素D正常组（≥50nm01／L）,比较各组免疫功能以及发生RRI的情况。结果维生素D缺乏组发生RRI的人数明显高于正常组的发生人数,有显著性差异（P〈0.05）。且维生素D缺乏组儿童的免疫功能明显低于正常组的儿童,主要表现在IgA和CD3＋以及NK的降低,有显著性差异（P〈0.05）。结论维生素D缺乏可造成儿童体液及细胞免疫能力的降低,容易导致儿童反复呼吸道感染的发生,针对反复呼吸道感染的患儿及时补充维生素D,对降低呼吸道感染的再次发生起着积极的作用。     

Vitamin A Deficiency in Patients with Common Variable Immunodeficiency

Vitamin A, a naturally occuring antioxidant micronutrient, has immunomodulating effect in patients with immunodeficiency, including an influence on cytokine production and lymphocyte growth and functions. Vitamin A deficiency is associated with a shift from type 2 cytokines to predominantly type 1 cytokines. The aims of this study were to determine Vitamin A status in Common variable immunodeficiency (CVID) patients and the relationship between Vitamin A status and cytokines production. Serum Vitamin A, neopterin, TNF-alpha, IL-2, IL-4, and IL-10 levels were determined in 19 CVID patients and 15 healthy children. Effects of 9-cis retinal, Vitamin A derivative, on cytokines (TNF-alpha, IL-2, IL-4 and IL-10) production in lymphocytes were tested in vitro condition using lymphocyte cultures obtained from CVID patients and healthy children.Serum Vitamin A level in CVDI patients was, 21.1± 1.5 μg/dL, significantly (p < 0.001) lower than the value, 35.7± 1.8 μg/dL, observed in healthy children. Serum neopterin level in the patients was, 9.8± 2.9 nmol/L, higher (p < 0.05) than the value, 3.9± 0.7 nmol/L, observed in control group. Common variable immunodeficiency patients, serum IL-4 level was significantly (p < 0.05) lower than the value observed for healthy children. Serum TNF-alpha, IL-2 and IL-10 levels were similar in the patients and healthy children. Vitamin A derivative, 9-cis retinal, increased TNF-alpha and IL-4 production in cultured mononuclear cells obtained from control and CVID patients. Vitamin A derivative, also, increased IL-2 and Il-4 production in cultured mononuclear cells obtained from CVID patients.These results show that CVID patients have low serum Vitamin A levels and high serum neopterin levels. A supplementation with Vitamin A may have role in downregulation of inflammatory responses in CVID patients.The contributions by Sara Sebnem Kilic and Esra Yapici Kezer are equal and the order of authorship is arbitrary.     

Vitamin D Deficiency in Adult Sickle Cell Patients

Introduction

Vitamin D levels in adult black Americans with sickle cell disease (SCD) are comparatively lower than those found in the general population of black Americans. The objectives of this study were to examine the prevalence of Vitamin D deficiency (VDD) in adults with various subtypes of sickle cell disease and identify risk factors for vitamin D deficiency.

孕妇血清维生素A、维生素E、25-羟基维生素D与 子痫前期的相关性研究

目的 探讨孕妇血清维生素A、维生素E、25-羟基维生素D水平与子痫前期的相关性。方法 选择2016年3月~2017年10月在我院产检的单胎孕妇为研究对象,其中子痫前期组72例,健康对照组30例。分析血清维生素A、维生素E、25-羟基维生素D水平与子痫前期的相关性及其诊断价值。结果 在孕10~14周时,两组孕妇孕血清维生素A、维生素E 、25-羟基维生素D水平比较,差异无统计学意义（P＞0.05）;孕24~28周时,子痫前期组血清维生素A、维生素E 、25-羟基维生素D水平低于对照组水平（P＜0.05）;多因素Logistic回归分析结果显示,孕24~28周血清维生素A、维生素E、25-羟基维生素D水平与子痫前期发病具有显著的相关性;回归模型显示,血清维生素A诊断子痫前期的AUC为0.976,95%CI为0.931~1.000,当界值为0.46时,预测子痫前期发病的灵敏度为95.70%,特异度为72.50%;维生素E诊断子痫前期的AUC为0.820,95%CI为0.725~0.914,当界值为0.28时,预测子痫前期发病的灵敏度为76.70%,特异度为77.80%;25-羟基维生素D诊断子痫前期的AUC为0.789,95%CI为0.681~0.898,当界值为0.33时,预测子痫前期发病的灵敏度为73.30%,特异度为81.90%;血清维生素A+维生素E+25-羟基维生素D诊断子痫前期的AUC为0.988,95%CI为0.966~1.000。当界值为0.55时,预测子痫前期发病的灵敏度为96.70%,特异度为95.80%。结论 在孕10~14周时,血清维生素A、维生素E、25-羟基维生素D水平下降与子痫前期发病无关;在孕24~28周时,血清维生素A、维生素E、25-羟基维生素D水平下降与子痫前期发病显著相关,孕晚期血清维生素A、维生素E、25-羟基维生素D可作为子痫前期的关键指标。     

Changes in lymphoid organs and blood lymphocytes induced by vitamin A deficiency and Newcastle disease virus infection in chickens

The effect of vitamin A deficiency in the presence or absence of Newcastle disease virus infection (NDV, La Sota strain) on weight of lymphoid organs and on the number and type of circulating white blood cells (WBC) was investigated in chickens. Day-old chickens with limited vitamin A reserves were fed purified diets containing either marginal (ad libitum) or adequate (pair-fed) levels of vitamin A and at 21–28 days of age; half the chickens in each group were infected with NDV. Vitamin A deficiency resulted only in significantly lower absolute and relative weights of bursa of Fabricius and after infection both weights of bursa and thymus were significantly lower. Relative weight of spleen was significantly higher after infection irrespective of vitamin A status. Liver weights were not affected by vitamin A status and/or NDV infection. Both vitamin A deficiency and NDV infection resulted in lymphopenia, while the lowest number of WBC were observed in vitamin A-deficient chickens during the acute phase of NDV (5 days after infection). Subsequent to lymphopenia due to NDV infection, a marked lymphocytosis was observed in controls and to a lesser extent in vitamin A-deficient birds. These results indicate that vitamin A deficiency, which is aggravated by concomitant NDV infection, affects lymphoid cell systems.     

早期干预对晚发生性维生素K缺乏所致颅内出血预后的影响

目的　探讨早期干预对晚发性维生素K缺乏所致颅内出血预后的影响 .方法　将 4 8例晚发性维生素K缺乏所致颅内出血患儿分成干预组 2 8例和对照组 2 0例 ,干预措施包括用药、感知、视听、语言、动作等训练 .两组病例在生后 3、6、9、12、18个月时用心量表检测精神运动发育商 (DQ) ,比较两组DQ及预后情况 .结果　干预组在 9、12、18个月龄时DQ高于对照组 (p<0 .0 1) .预后不良率低于对照组 (p<0 .0 5 ) .结论　早期干预能有效地促进晚发生性维生素K缺乏所致颅内出血智力发育 ,是改善预后 ,减少和减轻后遗症发生率的有效手段     

Laryngeal Spasm Mimicking Asthma and Vitamin D Deficiency

We present a woman with heterozygous carnitine palmitoyl transferase 2 (CPT-2) deficiency who in the last 6 months suffered from episodic dyspnea and choking. Symptoms could not be attributed to her muscular energy defect, since heterozygous CPT-2 deficiency is usually asymptomatic or causes only mild muscle fatigability. Myopathy is usually triggered by concurrent factors, either genetic (additional muscle enzymes defects) or acquired (metabolic stress). The patient was referred to our respiratory clinic for suspect bronchial asthma. Spirometry showed mild decrease in inspiratory flows. Methacholine challenge was negative. Dyspnea was triggered by hyperventilation-induced hypocapnia, which produced marked decrease in airflow rates, particularly in inspiratory flows, consistent with laryngospasm. Nutritional assessment of the patient showed low serum level of calcium and vitamin D, attributable to avoidance of milk and dairy products for lactose intolerance and to insufficient sunlight exposure. After calcium and vitamin D supplementation episodic laryngospasm disappeared and hypocapnic hyperventilation test induced very mild change in airflow rates. Calcium and vitamin D deficiency may favour laryngeal spasm mimicking asthma, particularly in subjects with underlying myopathy.     

腹泻病儿血中维生素A,锌,铜含量变化的研究

1990年6月至10月在新乡市医院选择新入院6月至5岁腹泻病儿80例和在门诊选择同年龄健康儿童21例,静脉取血测定其血中维生素A、锌、铜的含量及免疫球蛋白的含量。研究结果表明腹泻病儿血中维生素A(26.4±14.6μg/dl)明显低于健康儿童(54.9±17.0μg/dl)。有统计学上显著性差异(P<0.01),血清锌含量和铜/锌比值腹泻病儿为95.0±46.0μg/dl和1.51±0.44,健康儿童为127.4±34.3μg/dl和1.02±0.40,均有显著性差异(P<0.01),血清铜含量两组儿童无差异。免疫球蛋白IgA和IgG两组儿童无差异,而IgM的含量腹泻病儿明显高于健康儿童,有显著性差异。本文研究结果说明维生素A的不足或缺乏会增加腹泻病发生的危险性,若改善儿童的维生素A的营养状况可能会减少腹泻病发生的机会。     

Vitamin D and systemic lupus erythematosus - The hype and the hope

Over the past 20 years, much has been written about the potential role of vitamin D in on adverse health outcomes. In recent years, evidence has accumulated regarding the effect of vitamin D on the immune system, and its different cells. Some studies have noted lower vitamin D concentrations in patients with SLE. These epidemiological data still not answer the question: is vitamin D deficiency the cause or the effect? To answer this, we will discuss the association between vitamin D deficiency and SLE and review the evidence from interventional studies.     

常住北京市城区少儿血清维生素A和25-羟基维生素D水平分析

目的:检测北京市城区少儿冬季血清维生素A(VA)和25-羟基维生素D(25-OH VD)水平,分析营养状况。方法:2012年12月至2013年2月本院儿童保健门诊体检的0-14岁少儿292例,按年龄分为0-1岁、2-3岁、4-6岁和7-14岁四组,完成问卷调查和体格检查后,采用高效液相色谱法测定每例少儿血清VA水平,采用高效液相质谱串联法测定每例少儿血清25-OH VD水平,分析各年龄组VA、25-OH VD水平差异及每组低水平VA、25-OH VD检出率。结果:(1)292例少儿血清VA平均水平为(1.09±0.29)μmol/L,不同年龄组VA水平有显著性差异(F=10.96,P0.01),以0-1岁组最低(0.9±0.31)μmol/L;所有受检少儿低水平VA检出率为43.84%(128/292),不同年龄组低水平VA检出率有显著性差异(χ2=34.74,P0.01),0-1岁组检出率最高(76.32%)。(2)292例少儿血清25-OH VD平均水平(22.12±8.51)ng/ml,不同年龄组水平有显著性差异(F=7.56,P0.01),7-14岁组最低(18.34±6.34)ng/ml;所有受检者中低水平25-OH VD检出率为80.17%(233/292),不同年龄组低水平25-OH VD检出率有显著性差异(χ2=13.79,P0.05),4-6岁组最高(87.05%)。结论:冬季,常住北京市城区0-1岁幼儿的VA最低,7-14岁的25-OH VD最低,值得关注。