川崎病患儿25-羟基维生素D_3水平变化及意义

目的研究川崎病(KD)患儿血清25-羟基维生素D325-(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(P0.05),以CAL组最低(P0.05);上感组、IVIG敏感组和IVIG无反应组25-(OH)D3水平均低于对照组(P0.05),以IVIG无反应组最低(P0.05)。IVIG治疗后:CAL组的25-(OH)D3水平低于NCAL组及对照组(P0.05);IVIG无反应组的25-(OH)D3水平低于IVIG敏感组及对照组(P0.05),以IVIG无反应组最低(P0.05)。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。

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

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.