目的：研究毛细支气管炎患儿血清25-（OH）D3与免疫球蛋白水平的变化及临床意义。方法采用酶联免疫法检测35例毛细支气管炎患儿急性期和恢复期及20例健康儿童血清25-（OH）D3水平，速率散射比浊法测定免疫球蛋白含量。结果毛细支气管炎患儿急性期血清25-（OH）D3、IgG及IgA水平明显低于健康儿童组，而血清IgE明显高于健康儿童组，差异均有统计学意义（P＜0.05）。毛细支气管炎患儿恢复期血清25-（OH）D3水平较急性期增高，而IgE水平较急性期降低，差异有统计学意义（P＜0.05）。与健康儿童组比较，毛细支气管炎患儿恢复期血清25-（OH）D3及IgA水平明显降低，而血清IgE明显增高，差异亦有统计学意义（P＜0.05）。毛细支气管炎患儿急性期血清25-（OH）D3水平与IgG、IgA呈正相关（分别r=0.36，P＜0.05；r=0.63，P＜0.01），与IgE呈负相关（r=-0.72，P＜0.01）。毛细支气管炎患儿恢复期血清25-（OH）D3水平与IgE呈负相关（r=-0.34，P＜0.05）。结论毛细支气管炎患儿血清25-（OH）D3水平降低及免疫球蛋白水平失衡，提示25-（OH）D3及免疫球蛋白在其发病中起重要作用。
Abstract
OBJECTIVE: To study the changes in the serum levels of 25-(OH)D3 and immunoglobulins in children with bronchiolitis, and the clinical significance of these changes. METHODS: Serum levels of 25-(OH)D3 were measured using ELISA in 35 children with bronchiolitis in the acute and recovery phases and 20 healthy children. Serum levels of immunoglobulins were determined by rate nephelometry. RESULTS: Compared with the healthy children, serum 25-(OH)D3, IgG and IgA levels in children with bronchiolitis in the acute phase were significantly lower and, in contrast, serum IgE levels were significantly higher (P＜0.05). Serum 25-(OH)D3 levels increased and serum IgE levels decreased significantly in the recovery phase compared with the acute phase in children with bronchiolitis (P＜0.05). However, compared with the healthy children, serum 25-(OH)D3 and IgA levels were significantly lower and serum IgE levels were significantly higher in children with bronchiolitis in the recovery phase (P＜0.05). Serum 25-(OH)D3 levels in children with bronchiolitis in the acute phase were positively correlated with serum IgG (r=0.36, P＜0.05) and IgA levels (r=0.63, P＜0.01), and negatively correlated with serum IgE levels (r=-0.72, P<0.01). A negative correlation was found between serum 25-(OH)D3 and IgE levels in children with bronchiolitis in the recovery phase (r=-0.34, P＜0.05). CONCLUSIONS: Serum 25-(OH)D3 levels decrease and there is immunoglobulin level imbalance in children with bronchiolitis, suggesting that 25-(OH)D3 and immunoglobulins may play important roles in the pathogenesis of bronchiolitis.
关键词
毛细支气管炎 /
25-（OH）D3 /
免疫球蛋白 /
儿童
Key words
Bronchiolitis /
25-(OH)D3 /
Immunoglobulin /
Child
{{custom_sec.title}}
{{custom_sec.title}}
{{custom_sec.content}}
参考文献
［1］朱萍，邹丽萍.毛细支气管炎患儿外周血单个核细胞CD40/CD40L的表达［J］. 中国当代儿科杂志，2009，11（5）：354-356.
［2］Berger A.TH1 and TH2 responses: what are they［J］. BMJ, 2008, 321(7258): 424-430．
［3］Hansdottir S, Monick MM, Hinde SL, Lovan N, Look DC, Hunninghake GW. Respiratory epithelial cells convert inactive vitamin D to its active form: potential effects on host defense［J］.J Immunol, 2008, 181(10): 7090-7099.
［4］Leis KS, McNally JD, Montgomery MR, Sankaran K, Karunanayake C, Rosenberg AM.急性下呼吸道感染儿童的维生素D摄入［J］.中国当代儿科杂志，2012，14（1）：1-6.
［5］胡亚美，江载芳.诸福棠实用儿科学［M］.第7版.北京:人民卫生出版社，2002：1175-1201.
［6］杜秋映，于立君，范慧子，仰署芬，李国庆. 维生素D缺乏与毛细支气管炎发病的关系［J］. 实用儿科临床杂志，2011，26（4）：304-305.
［7］马秀丽，甄艳芬.支气管哮喘儿童血清25-(OH)D3和总免疫球蛋白Ｅ的变化［J］.中国当代儿科杂志，2011，13（7）：551-553.
［8］Martineau AR, Wilkinson RJ, Wilkinson KA, Newton SM, Kampmann B, Hall BM, et at. A single dose of vitamin D enhances immunity to mycobacteria［J］. Am J Respir Crit Care Med, 2007, 176(2): 208213.
［9］Staeva-Vieira TP, Freedman LP. 1,25-dilydroxyvitamin D3 inlvibits IFN-gamma and IL-4 Levels during in vitro Polarization of primary murine CD4+ T cetts［J］. J Immunot, 2002, 168(3): 1181-1189.
［10］赵晓云，肖志辉.新生儿呼吸道合胞病毒肺炎临床特点分析［J］.中华现代儿科学杂志，2009，6（1）：16-19.
［11］Hewison M. Vitamin D and the immune system: new perspectives on an old theme［J］. Endocrinol Metab Clin North Am, 2010, 39(2): 365-379.
［12］Karatekin G, Kaya A, Salihoｇlu O, Balci H, Nuhoˇｇlu A. Association of subclinical vitamin D deficiency in newborns with acute lower respiratory infection and their mothers［J］. Eur J Clin Nutr, 2009, 63(4): 473-477.
［13］朱亚非，朱建央，李卫武，蓝陈福，方静，林海玲. 毛细支气管炎CD4+CD25+调节性T细胞和Foxp3 mRNA表达及与IgE关系［J］.中国当代儿科杂志，2009，11（5）：349-353.
［14］郁志伟，谢婿娟.毛细支气管炎患儿血清IL-4，IgE测定及与哮喘的相关性研究［J］. 中国优生与遗传杂志，2005，13（7）：131-133.
［15］夏俊波，宋云熙，曾雪峰，王彦，王长征. 1，25-二羟维生素D3处理树突状细胞在过敏性气道炎症中的作用［J］.第三军医大学学报，2008，30（8）：743-745.
［16］Hypponen E, Berry DJ, Wjst M, Power C. Serum 25-hydroxyvitamin D and IgE-a significant but nonlinear relationship［J］. Allergy, 2009, 64(4): 613-620.
［17］马雅心，威好文.维生素D3联合地塞米松对哮喘大鼠的治疗作用及机制［J］.第四军医大学学报，2008，29（15）：1407-1409.
PDF(936 KB)
