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目的探讨学龄前反复呼吸道感染儿童维生素A水平与免疫功能变化。方法选取2013年2月-2014年2月间在该院儿科门诊确诊的71例反复呼吸道感染儿童为观察组,选取同期在该院保健门诊进行体检的71例健康儿童为对照组。采用荧光分光光度法、流式细胞术、淋巴细胞体外增殖对两组儿童血清维生素A水平和免疫功能进行检测。结果观察组儿童血清维生素A水平明显低于对照组,差异有统计学意义(P<0.05);观察组中亚临床维生素A缺乏(SVAD)和可疑SVAD儿童比例明显高于对照组,差异有统计学意义(P<0.01)。观察组儿童CD3~+绝对数、CD4+绝对数和百分数、CD4~+/CD8~+比值均明显低于对照组儿童,差异均有统计学意义(P<0.05,P<0.01);CD8+绝对数和百分数明显高于对照组,差异有统计学意义(P<0.05)。观察组儿童白细胞分化抗原百分数为明显低于对照组,差异有统计学意义(P<0.05)。观察组儿童外周血INF-γ和IL-2水平均明显低于对照组,差异有统计学意义(P<0.05)。IL-10和IL-4水平均明显高于对照组,差异有统计学意义(P<0.01)。结论学龄前反复呼吸道感染儿童血清维生素A水平明显低于健康儿童,并存在有较高的SVAD和可疑SVAD发生率。同时伴有细胞免疫功能紊乱或降低,表现为T淋巴细胞亚群及细胞因子失衡。
Objective To investigate the changes of vitamin A levels and immune function in preschool children with recurrent respiratory tract infections. Methods Totally 71 children with recurrent respiratory tract infection diagnosed in pediatric outpatient department of our hospital from February 2013 to February 2014 were selected as the observation group and 71 healthy children in the same period were selected as the control group. Fluorescence spectrophotometry, flow cytometry and lymphocyte proliferation in vitro were used to detect serum vitamin A level and immune function in both groups. Results The level of serum vitamin A in observation group was significantly lower than that in control group (P <0.05). The proportion of subclinical vitamin A deficiency (SVAD) and suspicious SVAD in observation group was significantly higher than that in control group Significance (P <0.01). The absolute number of CD3 ~ +, CD4 + absolute and percentage, CD4 ~ + / CD8 ~ + ratio in observation group were significantly lower than those in control group (P <0.05, P <0.01) And the percentage was significantly higher than the control group, the difference was statistically significant (P <0.05). The percentage of leukocyte differentiation antigen in the observation group was significantly lower than that in the control group, the difference was statistically significant (P <0.05). The levels of INF-γ and IL-2 in the peripheral blood of the observation group were significantly lower than those of the control group (P <0.05). IL-10 and IL-4 levels were significantly higher than the control group, the difference was statistically significant (P <0.01). Conclusion Serum vitamin A levels in preschool children with recurrent respiratory tract infection were significantly lower than those in healthy children, and there was a higher incidence of SVAD and suspicious SVAD. Accompanied by cellular immune dysfunction or reduced, manifested as T lymphocyte subsets and cytokine imbalance.