维生素A对毛细支气管炎患儿免疫状态及预后的影响

目的:研究血清维生素A 水平对毛细支气管炎患儿的免疫状态及预后的影响。方法:本研究纳入76例毛细支气管炎患儿为研究对象。随机分为观察组40例和对照组36例,两组患儿接受相同的常规治疗及护理措施,同时观察组口服维生素A制剂,对照组口服安慰剂,比较两组患儿急性期临床症状缓解时间及住院时间、出院6 个月后随访情况及血清CD4+、CD8+、CD4+/CD8+、IgE、IgA 及IgG 水平。结果:两组患儿急性期比较,观察组在咳嗽缓解时间、哮鸣音消失时间及住院时间较对照组缩短(P<0.05)。治疗后,两组患儿血清CD4+、CD4+/CD8+、IgA、IgG 水平升高,而血清CD8+、IgE水平降低(P<0.05);观察组血清IgA、IgG、CD4+ 、CD4+/CD8+水平较对照组高(P<0.05),而血清CD8+、IgE 水平较对照组低(P<0郾05)。出院随访6个月,观察组患上呼吸道感染例数、再次喘息次数及再住院例数均较对照组少(P<0.05)。结论:血清维生素A 水平与毛细支气管炎发生、发展及预后存在一定的相关性。补充外源性维生素A 可以改善毛细支气管炎患儿急性期症状,缩短住院时间,并可影响患儿的免疫功能状态,改善远期预后。

Effect and Significance of Vitamin A on Immune Function and Prognosis in Children with Bronchiolitis

Objective: To study the effect of serum vitamin A on immune function and prognosis in children with bronchiolitis. Methods: Seventy-six children with bronchiolitis were enrolled to be randomly divided into observation group (n =40) and control group (n =36). Two groups were given the same routine treatment and nursing measures, in the meantime, the observation received oral vitamin A preparations and the control group was treated with placebo. The relief time of clinical symptoms and length of stay in the acute phase, the follow-up after 6 months of discharge and the serum CD4+ , CD8+ , CD4+ / CD8+ , IgE, IgA, and IgG levels of two groups were compared. Results: Compared with the control group, the relief time of cough, disappearance time of wheezing and length of stay in observation group were shorter than those in control group (P<0.05). After treatment, the serum CD4+ , CD4+ / CD8+ , IgA, IgG levels of two groups increased significantly, while the serum CD8+ and IgE levels decreased (P <0. 05). The serum IgA, IgG, CD4+ and CD4+/CD8+ levels in observation group were higher than those in control group (P<0.05), while the serum CD8+ and IgE levels were lower than those in control group (P<0.05). After 6 months of follow-up, the number of cases of upper respiratory tract infection, the number of recurrent asthma and the number of hospitalizations in observation group were less than those in control group (P<0.05). Conclusion: There is a certain correlation between serum vitamin A levels and the occurrence, development and prognosis of bronchiolitis. Supplementation of exogenous vitamin A can improve the acute phase symptoms of children with bronchiolitis, shorten the length of stay, affect the immune function of children and improve long-term prognosis.