过敏性紫癜患儿25-羟基维生素D_3水平变化及意义

目的研究过敏性紫癜(HSP)患儿25-羟基维生素D_325-(OH)D_3]水平的变化及意义。方法收集92例HSP患儿,根据是否合并紫癜性肾炎(HSPN)分为HSPN组(31例),以及未合并紫癜性肾炎的HSP组(61例);根据临床症状分组:仅表现为皮肤紫癜的22例为单纯组,合并关节症状的24例为关节症状组,合并消化道症状的20例为消化道症状组,同时合并关节症状及消化道症状的26例为混合症状组。选择同期42例健康儿童为对照组。通过酶联免疫法检测各组25-(OH)D_3水平。结果 HSP组、HSPN组的25-(OH)D_3水平均低于健康对照组(P0.05);HSPN组的25-(OH)D_3水平又低于HSP组(P0.05)。关节症状组、消化道症状组、混合症状组之间的25-(OH)D_3水平差异无统计学意义(P=0.22),但均低于单纯组(P0.01)。结论 HSP患儿25-(OH)D_3水平下降,以HSPN以及合并消化道、关节症状的更为显著,25-(OH)D_3水平下降可能作为HSP是否合并其它系统损害的预测指标。

Changes in 25-hydroxyvitamin D3 level in children with Henoch-Schönlein purpura

Objective To examine the changes in 25-hydroxyvitamin D3 25-(OH)D3] level in children with Henoch-Sch(o)nlein purpura (HSP) and its clinical significance.Methods A total of 92 HSP children were included in this study,and were divided into HSP nephritis (HSPN) group (31 cases) and HSP group (61 cases) based on the presence or absence of HSPN.Alternatively,the patients were divided into purpura alone group (22 cases),purpura with joint symptoms group (joint symptom group,24 cases),purpura with gastrointestinal symptoms group (gastrointestinal symptom group,20 cases),and purpura with joint and gastrointestinal symptoms (mixed group,26 cases) based on their clinical symptoms.In addition,42 healthy children were selected as healthy control group.The level of 25-(OH)D3 in each group was measured using enzyme-linked immunoassay.Results The 25-(OH)D3 level in the HSP and HSPN groups was significantly lower than that in the healthy control group (P＜0.05),and the 25-(OH)D3 level in the HSPN group was significantly lower than that in the HSP group (P＜0.05).Although there was no significant difference in the 25-(OH) D3 level between the joint symptom,gastrointestinal symptom,and mixed groups (P=0.22),the 25-(OH) D3 level in the three groups was all significantly lower than that in the purpura alone group (P＜0.05).Conclusions The level of 25-(OH)D3 is reduced in children with HSP,particularly those with HSPN or with joint and gastrointestinal symptoms.Therefore,the reduction in 25-(OH)D3 level may serve as a predictor of whether HSP is associated with other impairments.