摘要
目的分析反复呼吸道感染(RRTI)患儿血清维生素A水平变化及其对辅助性T细胞1/辅助性T细胞2(Th1/Th2)平衡的影响。方法回顾性选取2017年9月至2019年6月期间在徐州市儿童医院接受治疗的108例RRTI患儿作为研究对象(RRTI组),另选取同期于本院进行体检的健康儿童100例作为健康对照组,采用高效液相色谱法测定两组血清维生素A(>0.3mg/L划分为正常组,≤0.3mg/L划分为不足组)、白细胞介素4(IL-4)、白细胞介素6(IL-6)、γ-干扰素(IFN-γ)及Th1/Th2细胞亚群比值;采用受试者工作特征(ROC)曲线分析维生素A、Th1/Th2对RRTI患儿治疗后无效的预测价值。结果RRTI组血清维生素A水平低于健康对照组,差异有统计学意义(t=12.841,P<0.05);维生素A不足组Th1、Th1/Th2及IFN-γ水平均低于正常组(t值分别为13.653、30.010、53.329,P<0.05),Th2、IL-4及IL-6水平均高于正常组(t值分别为10.406、22.100、35.180,P<0.05);治疗无效组患儿血清维生素A水平和Th1/Th2均低于有效组,差异有统计学意义(t值分别为12.183、18.277,P<0.05);ROC曲线分析结果显示维生素A联合Th1/Th2预测RRTI患儿治疗后无效的曲线下面积为0.965,高于维生素A、Th1/Th2单独预测的0.722、0.862(Z=3.402,P<0.05)。结论RRTI患儿血清维生素A低于正常水平;与维生素A正常患儿相比,维生素A不足患儿的Th1/Th2、IFN-γ水平均较低,IL-4、IL-6水平较高;维生素A和Th1/Th2联合预测RRTI患儿疗效具有一定的价值。
Objective To investigate changes in serum vitamin A level and their effects on T helper cell 1/T helper 2(Th1/Th2)balance in children with recurrent respiratory tract infection(RRTI).Methods A total of 108 children with RRTI who were treated in Xuzhou Municipal Children′s Hospital from September 2017 to June 2019 were selected as study subjects(RRTI group).Other 100 healthy children who underwent physical examination in the same period were enrolled as healthy control group.High-performance liquid chromatography(HPLC)was used to detect serum levels of vitamin A,interleukin 4(IL-4),interleukin 6(IL-6),interferon-γ(IFN-γ)and ratio of Th1/Th2 of the children in the two groups.According to serum vitamin A level,they were divided into normal vitamin level group(>0.3mg/L)and vitamin A insufficiency group(≤0.3mg/L).Receiver operating characteristic(ROC)curve was drawn to analyze predictive values of vitamin A and Th1/Th2 for treatment ineffectiveness in RRTI children.Results The serum level of vitamin A in the RRTI group was lower than that in the healthy control group,and the differences was significant(t=12.841,P<0.05).The serum levels of Th1,Th1/Th2 and IFN-γof the children in the vitamin A insufficiency group were lower than those in the normal vitamin A level group,and the differences were significant(t=13.653,30.010 and 53.329 respectively,all P<0.05),while the serum levels of Th2,IL-4 and IL-6 were significantly higher than those in the normal vitamin A level group(t=10.406,22.100 and 35.180 respectively,all P<0.05).The serum level of vitamin A and Th1/Th2 ratio of the children in the ineffective group were lower than those in the effective group,and the differences were significant(t=12.183 and 18.277 respectively,both P<0.05).The results of ROC curve analysis showed that area under the curve(AUC)of vitamin A combined with Th1/Th2 for predicting treatment ineffectiveness was 0.965,which was greater than that of vitamin A(0.722)and Th1/Th2(0.862)alone(Z=3.402,P<0.05).Conclusion The serum level of vitamin A of RRTI children is under normal level.Compared with these children with normal serum vitamin A level,the serum levels of Th1/Th2 and IFN-γof those children with vitmin A insufficiency are lower,while their serum levels of IL-4 and IL-6 are higher.Combination of vitamin A and Th1/Th2 is of certain predictive value for curative effect in RRTI children.
作者
石银月
纵书芳
王洁
孙浩淼
SHI Yinyue;ZONG Shufang;WANG Jie;SUN Haomiao(Department of Infectious Diseases,Xuzhou Municipal Children's Hospital,Jiangsu Xuzhou 221000,China)
出处
《中国妇幼健康研究》
2023年第2期99-103,共5页
Chinese Journal of Woman and Child Health Research
