维生素D对婴幼儿肺炎的临床价值探讨

目的:探讨婴幼儿肺炎血清25(OH)D3水平的变化及维生素D辅助治疗婴幼儿肺炎的临床疗效。方法:选取我院因肺炎住院的78例婴幼儿作为肺炎组,按临床症状轻重不同分成轻症组和重症组,另外选取儿童保健门诊体检的62例婴幼儿作对照组,测定所有患儿血清25(OH)D3水平。再将肺炎组患儿随机分为维生素D治疗组和非治疗组,两组均给予常规的抗感染以及对症支持治疗,治疗组在常规治疗基础上给予维生素D治疗1周,治疗前及治疗后1周分别检测血清25(OH)D3水平,同时比较两组患儿临床疗效。结果:(1)婴幼儿肺炎组血清25(OH)D3水平低于正常对照组,差异有统计学意义(P<0.01)。(2)重症肺炎组血清25(OH)D3水平低于轻症肺炎组,差异有统计学意义(P<0.01)。(3)治疗7 d后,维生素D治疗组血清25(OH)D3水平高于治疗前,差异有统计学意义(P<0.01)。(4)维生素D治疗组的体温恢复正常时间、咳嗽气喘消失时间、肺部啰音消失时间、住院时间均较非治疗组短,差异有统计学意义(P<0.05)。(5)维生素D治疗组总体有效率97.4%,高于非治疗组的82.1%,差异有统计学意义(P<0.05)。结论:维生素D 缺乏可能是婴幼儿肺炎的诱因之一,在判断疾病轻重上也有一定的意义,维生素D 辅助治疗婴幼儿肺炎可缩短病程、改善疗效。

Clinical Value of Vitamin D in Pneumonia for Infants

Objective: To investigate the changes of serum level of 25(OH)D3 and the clinical effect of the adjuvant treatment of vitamin D for infants with pneumonia. Methods: Seventy eight infants in hospital due to the pneumonia of our hospital were selected as pneumonia group, according to the different clinical symptoms, they were divided into mild pneumonia group and severe pneumonia group, and 62 infants who had the physical examinations from Child Health Care Service as the control group. The levels of serum 25(OH)D3 of all the children were tested respectively. Then randomly divided infants with pneumonia into vitamin D treatment group and non-vitamin D treatment group, the two groups were given conventional anti-infection and symptomatic treatment, the vitamin D treatment group was also treated with vitamin D for one week. The differences of serum levels of 25(OH)D3 before and after treatment in one week and the clinical efficacy of the two groups were compared. Results: (1) The level of serum 25(OH)D3 of infants with pneumonia was lower than that in the control group, the difference had statistical significance (P<0.01). (2) The serum level of 25(OH)D3 with the severe pneumonia group was lower than that of the mild pneumonia group, the difference was statistically significant (P<0.01). (3) After the treatment of seven days, serum level of 25(OH)D3 in the vitamin D treatment group was higher than that before the treatment, the difference had statistical significance (P<0.01). (4) For the Vitamin D treatment group, the body temperature returning to the normal level, the time of disappearance of cough and asthma; the time of disappearance of the pulmonary rale, days of hospitalization were all shorter than non-vitamin D treatment group, the differences were statistically significant (P<0.05). (5) The total effective rate of the vitamin D treatment group was 97.4%, it was higher than that of the non-vitamin D treatment group with 82.1%, the difference was statistically significant (P<0.05). Conclusion: Vitamin D deficiency may be one of the reasons of infants pneumonia, also has some significance for determining disease severity, and vitamin D can shorten the course of treatment and improve the therapeutic effect, so the prevention and treatment of Vitamin D deficiency in infants should be clinically strengthened.