维生素D对儿童反复呼吸道感染免疫调节作用的研究

目的探讨维生素D对儿童血清25-羟维生素D325-(OH)D3]、IgA、IgM、IgG水平的影响及反复呼吸道感染(RRI)的治疗效果。方法选取2011年1月²011年12月在我院儿科门诊就诊的RRI患儿113例,采用随机数字表法分为补维生素D组(57例)和观察组(56例),另选取同期健康体检的儿童为对照组(62例),补维生素D组和观察组均按呼吸道感染予常规治疗,补维生素D组另给予阿法骨化醇胶囊口服,对所有的RRI患儿随访1年,观察并记录呼吸道感染的复发次数,并检测三组不同时期血清25-(OH)D3、IgA、IgM、IgG水平。结果补维生素D组和观察组治疗总有效率分别为96.49%、67.86%,差异有统计学意义(P<0.001);治疗后补维生素D组患儿呼吸道感染次数明显减少,与观察组比较差异有统计学意义(P<0.001);补维生素D组治疗后血清25-(OH)D3和IgA、IgM、IgG水平明显升高(P<0.01),观察组各项指标改变不明显(P>0.05),两组比较差异有统计学意义(P<0.01)。结论 RRI患儿存在血清25-(OH)D3低水平和体液免疫功能降低,适当地补充维生素D能调节机体免疫功能,减少呼吸道感染发生频率。

Role of vitamin D in immunoregulation of children with recurrent respiratory tract infection

Objective To investigate the effect of Vitamin D on children serum 25-hydroxy vitamin D3 25 （OH）D3 ],IgA,IgM and IgG and the efficacy in treatment of recurrent respiratory infection （RRI）. Methods From January 2011 to December 2011,a total of 113 outpatients of RRI children from pediatric de-partment of our hospital were chosen and divided into a vitamin D supplement group （57 cases）and an observa-tion group （56 cases）by using the random number table method,meanwhile,62 children participated health physical examination at the same period were selected as the control group.Vitamin D supplement group and observation group were treated for respiratory tract infection routinely.In addition,Vitamin D supplement group were administered oral Alfacalcidol Capsule.One-year follow-up for RRI children was done.The fre-quency of respiratory tract infection recurrence were observed and recorded.Serum 25 （OH）D3 ,IgA,IgM and IgG levels of three groups at different time points were measured. Results The total effective rate of vitamin D supplement group and observation group were 96.49%、67.86%,respectively.The difference was statistical-ly significant （P 〈0.001）.After treatment,respiratory tract infection frequency of children in vitamin D sup-plement group decreased significantly,compared with observation group,there was statistically significant difference （P 〈0.001）.Serum 25 （OH）D3 ,IgA,IgM and IgG levels in vitamin D supplement group elevated significantly （P 〈0.01）.The changes of indicators in observation group were quiet（P 〉0.05）.Difference of two group was statistically significant（P 〈0.01）. Conclusion The serum 25-（OH）D3 of RRI children was low and their humoral immune function decreased.Proper Vitamin D supplements could adjust the physical im-mune function and reduce respiratory infection frequency.