儿童特应性皮炎严重度与25羟维生素D、总IgE及IL-4水平的相关性研究

 目的:探讨儿童特应性皮炎（AD）的严重度与血清25羟维生素D［25(OH)D］、总免疫球蛋白E（tIgE）及IL 4水平的相关性。方法：选取本院就诊的160例AD患儿，以AD严重度评分（SCORAD）评估分级，采用高效液相色谱法检测血清25(OH)D，采用化学发光法检测血清tIgE，采用酶联免疫吸附法检测血清IL-4，分析血清25 (OH) D水平、tIgE、IL-4水平与 AD患者SCORAD评分的相关性。结果：根据SCORAD评分，AD患儿轻度55例（34.38%）、中度84例（52.50%）、重度21例（13.13%）。AD患儿血清25(OH)D与SCORAD评分、血清tIgE和IL-4水平均呈明显负相关(r值分别为-0.61、-0.48和-0.33,P值均＜0.001)，SCORAD评分与血清tIgE和IL-4均呈明显正相关(r值分别为0.80、0.71, P值均＜0.001)。结论：AD患儿严重度与血清25(OH)D水平呈负相关，维生素D是AD的保护性因子。血清tIgE和IL-4水平均与AD的严重度呈负相关，维生素D可能通过影响血清tIgE和调控炎症因子IL-4参与皮肤的免疫调节，从而影响AD的严重程度。

The correlation between severity of atopic dermatitis and serum levels of 25 hydroxyvitamin D,total IgE and IL-4 in children

Objective：To explore the correlation between severity of atopic dermatitis (AD) and serum 25 hydroxyvitamin D ［25(OH)D］, total immunoglobulin E (tIgE) and IL-4 levels in children. Methods: A total of 160 children with AD who were treated in our hospital were enrolled. The severity of AD was evaluated and graded with the SCORAD score. Serum 25(OH) D levels were detected by high performance liquid chromatography, total IgE (tIgE) levels were detected by chemiluminescence, and IL-4 levels were detected by enzyme linked immunosorbent assay. The correlation between serum 25(OH) D, tIgE, IL-4 level and SCORAD score were analyzed. Results:According to the SCORAD score, 55 cases (34.38%) were mild, 84 (52.50%) cases were moderate, and 21 (13.13%) cases were severe. The serum levels of 25(OH) D in children with AD were significantly negatively correlated with SCORAD score, serum tIgE and IL-4 levels all (r=-0.61,-0.48 and -0.33, respectively, all P<0.001). Furthermore, the SCORAD score were significantly positively correlated with serum tIgE and IL-4 levels (r=0.80，  0.71, respectively, both P<0.001). Conclusions:The serum 25(OH) D levels were negatively correlated with the severity of AD in children. Serum levels of 25(OH) D is a protective factor for AD. Serum tIgE and IL-4 levels were also negatively correlated with the severity of AD. Vitamin D may affect the severity of AD by affecting serum tIgE and regulating inflammatory factor IL-4 in skin immune regulation.