血清维生素D与重症手足口病患儿临床表现的关系
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南京医科大学科技发展基金(NMUB2018075)


The relationship between serum 25⁃hydroxyvitamin D and clinical manifestations in severe hand⁃foot⁃and⁃mouth disease
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    摘要:

    目的:探讨血清25-羟基维生素D[25(OH)D])浓度与重症手足口病(hand-foot-and-mouth disease,HFMD)的关系,评价25(OH)D浓度在HFMD患儿中的临床意义。方法:将126例HFMD患儿分为普通HFMD组(84例)、重症HFMD组(42例)。另选取同期门诊体检的58名健康儿童作为对照组。测定各组血清25(OH)D浓度,按血清25(OH)D浓度分为正常组(≥75 nmol/L)、不足组(≥50~75 nmol/L)和缺乏组(<50 nmol/L)。对HFMD儿童检测血清钙离子(Ca2+)、D-二聚体、乳酸脱氢酶和肌酸激酶-MB水平;用RT-PCR法进行肠道病毒核酸检测和分型鉴定。结果:各组血清25(OH)D浓度普遍较低。重症HFMD组血清25(OH)D浓度(50.0±10.2)nmol/L显著低于健康对照组(73.1±12.3)nmol/L和普通HFMD组(71.2±13.5)nmol/L;病原学分析显示重症HFMD组中人肠道病毒71型(Enterovirus 71,EV71)感染率显著高于普通HFMD组。Logistic回归分析显示血清25(OH)D浓度是影响HFMD患儿预后的独立因素。结论:血清25(OH)D浓度对判断危重HFMD及预测病情进展具有临床价值,但需要进一步验证25(OH)D浓度在HMFD诊断中的临床价值。

    Abstract:

    Objective:This study aims to investigate the relationship between serum 25-hydroxyvitamin[D25(OH)D] concentration and hand-foot-and-mouth disease(HFMD),and to evaluate the clinical significance of 25(OH)D concentrations in children with HFMD. Methods:Total 126 children with HFMD were divided into mild HFMD group(84 cases)and severe HFMD group(42 cases). Another 58 healthy children in the same period were selected as control group. Serum 25(OH)D concentrations were measured in all subjects,and all subjects were divided into 25(OH)D normal(≥75 nmol/L)group,25(OH)D insufficiency(≥50-75 nmol/L)group and 25(OH)D deficiency(< 50 nmol/L)group according to serum 25(OH)D concentration. Serum calcium,D-dimer,lactate dehydrogenase and creatine kinase-MB levels were also measured in children with HFMD. Enterovirus nucleic acid was detected and typed by RT-PCR. Results:Serum 25(OH)D concentrations were generally low in all groups. The average concentration of serum 25(OH)D in severe HFMD group[(50.2±10.2)nmol/L] was significantly lower than that in healthy control group[(73.1±12.3)nmol/L]and mild HFMD group[(71.2±13.5)nmol/L];EV71 infection rate in severe HFMD group was significantly higher than that in mild HFMD group. Logistic regression analysis showed that serum 25(OH)D concentration was an independent factor affecting the prognosis of HFMD children. Conclusion:Serum 25(OH)D concentration has clinical value in judging and predicting the progress of HFMD. Further evidence is needed to demonstrate the clinical value of 25(OH)D in diagnosis of HMFD.

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苍 旻,谢国锦,李松涛,周 晋.血清维生素D与重症手足口病患儿临床表现的关系[J].南京医科大学学报(自然科学版),2019,(9):1341-1344

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  • 收稿日期:2018-12-26
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  • 在线发布日期: 2019-09-29
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