维生素D缺乏与小儿呼吸道感染的关系探讨

目的探讨维生素D（VitD）缺乏与小儿呼吸道感染的关系。方法随机选取2010年1月-2013年6月在吉林市丰满区妇幼保健院门诊就诊的符合反复呼吸道感染诊断标准的患儿共80例为病例组,随机抽取健康儿童50例为健康对照组,比较病例组与健康对照组血清25-羟维生素D3（25-OH-VD3）水平。将病例组患者随机分为常规治疗组和补充VitD组,每组各40例,常规治疗组给予抗感染及对症治疗,补充VitD组在常规治疗组的基础上给予口服阿法骨化醇补充VitD治疗。3个月后复查血清25-OH-VD3水平。随访6个月,观察反复呼吸道感染复发次数。结果治疗前病例组血清25-OH-VD3水平为（23.41±7.13）nmol/L,明显低于健康对照组的（76.23±8.90）nmol/L（P〈0.05）。经过3个月的治疗,常规治疗组25-OH-VD3水平较治疗前基本无改变,而补充VitD组血清25-OH-VD3水平由治疗前的（23.29±6.15）nmol/L上升至（58.95±10.87）nmol/L,2组儿童治疗后25-OH-VD3水平比较差异有统计学意义（P〈0.05）。经过6个月的随访,补充VitD组呼吸道感染复发次数明显少于常规治疗组（P〈0.05）。结论反复呼吸道感染患儿经过补充VitD,血清25-OH-VD3水平可以得到明显提升,并减少呼吸道感染次数。

Investigation on the Relationship between Vitamin D Deficiency and Respiratory Infections in Children

Objective To investigate the relationship between vitamin D （VitD） deficiency and respiratory infections in children. Method 80 cases of child patients were selected as the patient group who were received in Fengman District Hospital of Maternal and Child Health from January 2010 to June 2013 and met the diagnostic criteria for recurrent respiratory infections. 50 cases of healthy children were randomly selected as the control group. The levels of serum 25-hydroxy vitamin D3 （25-OH-VD3） were compared between the two groups. The patient group were randomly divided into the conventional therapy group and VitD supplement group, 40 cases in each. The conventional therapy group was given antibiotic and symptomatic treatments and the VitD supplement group was received oral alfacalcidol supplement VitD under the treatment for the conventional therapy group. Three months later, the levels of serum 25-OH-VD3 were rechecked. During six-month followups, the relapse number of recurrent respiratory infections was recorded. Results Before the treatment, the level of serum 25-OH-VD3 in the patient group was （23.41±7.13） nmol/L, significantly lower than that of the control group with the level of （76.23±8.90） nmol/L（P〈0.05）. After three months of treatment, there was almost no significant change of serum 25-OH-VD3 level in the conventional therapy group but serum 25-OH-DV3 level in the VitD supplement group increased from （23.29 ± 6.15） nmol/L to （58.95 ± 10.87） nmol/L and there was a significant difference （P〈0.05）. After six months of follow-ups, the relapse number of respiratory infections in the VitD supplement group was significantly less than the conventional therapy group （P〈0.05）. Conclusion VitD supplement can significantly improve the level of serum 25-OH-VD3 in children with respiratory infections and reduce the relapse number of respiratory infections.