中国全科医学2017，Vol.20Issue(z2)：5-8,4.
血清25-OH-维生素D在儿童脓毒症发病机制中的研究
Effect of Serum 25-OH-VitD in the Pathogenesis of Sepsis in Children
摘要
Abstract
Objective To explore the effect of serum 25-OH-VitD in the pathogenesis of sepsis in children.Methods Fifty patients who were diagnosed as sepsis in the Pediatric Ward of Ruian People′s Hospital from January 2016 to January 2017 were selected as the experimental group,during the same period 50 normal children as the control group.Serum 25-OH-VitD,IL-2R,IL-4,IL-6 and IL-10 levels were detected.The children were divided into 3 groups according to their serum 25-OH-VitD levels:adequate group,insufficient group and lack group.The observation indexes of the 3 groups were compared.Then according to the prognosis of patients after 28 d,the children were divided into the improved group and the worsening group,to determine the independent risk factors affecting the prognosis of sepsis in children.Results The levels of IL-2R,IL-4 and IL-6 in the children in the adequate group,insufficient group and lack group were higher than that in the control group,and the level of IL-10 was lower than that in the control group(P<0.05).The levels of IL-2R,IL-4 and IL-6 in the children in the insufficient group and the lack group were higher than that in the adequate group,and the level of IL-10 was lower than that in the adequate group(P<0.05).The levels of IL-2R,IL-4 and IL-6 in the children in the lack group were higher than those in the insufficient group,and the level of IL-10 was lower than that in the insufficient group(P<0.05).In 50 children with sepsis,9 cases deteriorated within 28 d,and the other 41 cases improved.The levels of IL-2R,IL-4 and IL-6 in the worsening group were higher than those in the improved group(P<0.05),while the levels of 25-OH-VitD and IL-10 were lower than those in the improved group(P<0.05).Spearman correlation analysis showed that the levels of serum 25-OH-VitD in children with sepsis were negatively correlated with the rate of 28 d deterioration,serum IL-2R,IL-4 and IL-6 levels(r=-0.345,P<0.05;r=-0.264,P<0.05;r=-0.394,P<0.05;r=-0.615,P<0.05),positive correlation with IL-10 levels(r=0.151,P<0.05).Multivariate Logistic regression analysis showed that 25-OH-VitD levels were independent prognostic factors in children with sepsis(P<0.05).Conclusion 25-OH-VitD were independent predictors of prognosis in patients with severe sepsis.Vitamin D can affect the immune function of the body and the balance of pro-inflammatory/anti-inflammatory factors to lead to the pathogenesis and prognosis of sepsis.关键词
脓毒症/25-羟维生素D/儿童Key words
Sepsis/25-Hydroxyvitamin D/Child分类
医药卫生引用本文复制引用
黄梦,李克诚,徐旭,林洁..血清25-OH-维生素D在儿童脓毒症发病机制中的研究[J].中国全科医学,2017,20(z2):5-8,4.基金项目
温州市科技计划项目(Y20160238) （Y20160238）
