小儿热性惊厥与血清25-羟基维生素D水平关联分析

目的了解安徽省郎溪县热性惊厥小儿血液中25-羟基维生素D[25(OH)D]水平以及与患儿儿年龄大小、性别、四季之间的联系，进而为小儿口服维生素D、预防以及减少小儿热性惊厥的发生提供临床参考依据。方法将2015-2019年郎溪县人民医院儿科住院诊断为热性惊厥的小儿306例作为热性惊厥组，选取同期因呼吸道感染住院的0~8岁小儿306例作为非热性惊厥组。统计所有小儿血清总钙(Ca2+)、血红蛋白(Hb)以及25(OH)D测定的数值，按年龄大小、性别、春夏秋冬四季等解析热性惊厥和25(OH)D水平之间的联系。结果非热性惊厥组血清25(OH)D水平为(34.47±1.43) μg/L，高于热性惊厥组的(27.57±4.44) μg/L(t＝3.26，P < 0.05)；热性惊厥组25(OH)D水平高低与患儿年龄成反比；热性惊厥者的血清总钙以及Hb都在正常参考值范围。热性惊厥发生情况:最易发生的季节是每年的1月份(39例，12.75%)，1~2岁最易发生(106例，34.64%)，男性发病多于女性(1.53∶1.00)。郎溪县热性惊厥小儿血清25(OH)D水平在四季之间差异有统计学意义(P < 0.01): 从高到低依次为秋季(30.39±4.15) μg/L、春季(29.33±1.53) μg/L、夏季(27.28±2.98) μg/L、冬季(24.69±2.08) μg/L。热性惊厥小儿血清25(OH)D水平(?)与气温(X)的回归方程为: ?=-0.045X2+2.107X+9.442(R2=0.844)。结论安徽省郎溪县小儿热性惊厥的发生和维生素D缺乏存在关联性。热性惊厥最易发生的季节是每年的1月份，1~2岁男性患儿多见。夏季温度>30 ℃后热性惊厥小儿血液25(OH)D含量开始减少。17~33 ℃是郎溪县小儿经阳光照射皮肤途径产生维生素D的合适温度。除了在冬季常规给小儿补充维生素D外，为减少热性惊厥的发生，应在夏季高温酷暑期对小儿(特别是>2岁者)适当口服维生素D。

Correlation analysis between febrile seizure and serum level of 25-hydroxy vitamin D

ObjectiveTo investigate the serum levels of 25-hydroxy vitamin D[25(OH)D] of children with febrile seizure in Langxi County, analyze the correlation of 25(OH)D with children's age, gender and seasons, and provide a clinical reference for supplementing vitamin D, preventing and decreasing the incidence rate of febrile seizure in children.MethodsThree hundred and six inpatient children diagnosed by febrile seizure in the Pediatric Department of Langxi County People's Hospital from January 2015 to December 2019 were set as the febrile seizure group, and 306 inpatient children with respiratory infections(aged 0-8 years old) during the same period were set as the non-febrile seizure group.The serum levels of total calcium, 25(OH)D and hemoglobin(Hb) in two groups were examined.The correlation of the febrile seizure with serum level of 25(OH)D was analyzed from the aspects of children age, gender and seasons.ResultsThe serum level of 25(OH)D in the non-febrile seizure group was(34.47±1.43)μg/L, which was higher than that in the febrile seizure group[(27.57±4.44)μg/L](t=3.26, P < 0.05).The serum level of 25(OH)D in the febrile seizure group was inversely proportional with the age of children, and the total serum calcium and Hb of the patients with febrile seizures were in the normal rang.For the occurrence of febrile seizures, the most common season was January(39 cases, 12.75%), the most common age was 1-2 years old(106 cases, 34.64%), and the incidence rate of febrile seizure in male was more than that in female(1.53∶1.00).The differences of the serum levels of 25(OH)D of children with febrile seizure in Langxi county among four seasons were statistically significant(P < 0.01).The serum levels of 25(OH)D in autumn, spring, summer and winter were(30.39±4.15)μg/L, (29.33±1.53)μg/L, (27.28±2.98)μg/L, and(24.69±2.08)μg/L, respectively.The regression equation between serum 25(OH)D level(?) and air temperature(X) in children with febrile seizure was ?=-0.045X2+2.107X+9.442(R2=0.844).ConclusionsThe occurrence of febrile seizure in children is correlated to the vitamin D deficiency.The 1-2 years old boys are most vulnerable to febrile seizures in January each year.The serum 25(OH)D content in children with febrile seizure begins to decrease after summer temperature >30 ℃.The 17-33 ℃ is the suitable temperature for children in Langxi County to produce vitamin D when their skin is exposed to sunlight.In addition to regular supplementation of vitamin D in winter, the children(especially those >2 years old) should take vitamin D orally in summer in order to reduce the occurrence of febrile seizure.