维生素D佐治儿童社区获得性肺炎的临床研究

摘要

目的 探讨维生素D佐治社区获得性肺炎儿童的血清碱性磷酸酶(AKP)、25羟维生素D3[25-(OH)D3]以及免疫球蛋白A (ImmunoglobulinA,IgA)的变化及临床疗效.方法 将我科室于2011年10月至2012年5月期间收治的76例社区获得性肺炎患儿随机分为VitD治疗组和对照组各38例,对照组患儿采用常规抗炎、抗病毒及其他对症治疗,治疗组在此基础上服用阿法骨化醇胶囊,在治疗前及治疗后1个月分别检测患儿AKP、25-(OH)D3以及IgA水平,同时比较两组患儿的临床疗效.结果 ①治疗1个月后,VitD治疗组临床疗效痊愈率(92.1％)及总体有效率(100.0％)均高于对照组(68.4％、89.5％),且前者差异具有统计学意义(P＜0.05)；②治疗1个月后,VitD治疗组AKP为(225.48±77.44) U/L、25-(OH)D3为(77.84±21.12) nmol/L及IgA为(0.43±0.16) g/L等生理生化指标均优于对照组的(289.14±111.73) U/L、(35.18±13.55) nmol/L、(0.31±0.06) g/L,差异有统计学意义(P＜0.05).结论 辅以补充足量的VitD可缩短社区获得性肺炎疗程、改善疗效、提高儿童呼吸系统免疫力,VitD缺乏可能是儿童社区获得性肺炎的潜在病因.%Objective To investigate the clinical efficacy of vitamin D for adjuvant treatment of community-acquired pneumonia (CAP) in children, and to study the corresponding variance of alkaline phosphatase (AKP), 25-(OH)D3, immunoglobulin A (IgA). Methods Seventy-six children of CAP admitted from Oct. 2011 to Mar. 2012 were randomized into the study group and control group, with 38 patients in each group. The control group was applied conventional anti-infection, anti-viral therapy and symptomatic treatment, while the study group applied alfacal-cidol capsules based on the control group. The clinical efficacy and variance of AKP, 25-(OH)D3, IgA were detected and compared between the two groups before treatment and ont month after treatment. Results ①One month after treatment, the cure rate and overall effective rate of the study group (92.1% and 100.0%, respectively) were significantly higher than those of the control group (68.4% and 89.5%, respectively), P<0.05. ② One month after treatment, the levels of AKP, 25-(OH)D3 and IgA of the study group [(225.48±77.44) U/L, (77.84±21.12) nmol/L and (0.43±0.16) g/L, respectively] were all significantly better than those of the control group [(289.14± 111.73) U/L, (35.18± 13.55) nmol/L, (0.31±0.06) g/L], P<0.05. Conclusion Vitamin D deficiency may be the underlying cause of CAP in children. Adequate supplementation of Vitamin D can shorten the course of treatment, improve curative efficacy, and enhance immunity of respiratory system in children with CAP.