| Objective:By detecting the serum levels of 25(OH)D and TGF-beta 1 in children with Mycoplasma pneumoniae pneumonia(MPP)complicated by wheezing,we understand the deficiency of VitD in children with MPP complicated by wheezing,and explore the immunomodulatory role of VitD in wheezing induced by MPP,so as to provide new ideas for early recognition and prevention of bronchial asthma.Methods:Sixty children with acute MPP who were hospitalized in pediatrics department of the Second Hospital of Jilin University from October 2018 to December 2018 were divided into MPP with wheezing group(32 cases)and MPP without wheezing group(28 cases)according to whether the children had wheezing symptoms and whether there was wheezing sound in the lung auscultation.Twenty healthy children matched with the two groups in age,sex and visiting time were collected as control group.Serum 25(OH)D and TGF-beta 1 levels were measured by ELISA in all subjects.Meanwhile,clinical data of hypersensitive C-reactive protein,alkaline phosphatase,lactate dehydrogenase,serum calcium,phosphorus,immunoglobulin,lung function and exhaled NO in children with MPP were collected,to compare the differences of the above-mentioned clinical indicators between MPP with wheezing group,MPP without wheezing group,control group and children with MPP with VitD deficiency/insufficiency group and VitD normal group,and to analyze the correlation between VitD and various clinical indicators,in order to explore the influence of serum 25(OH)D level on the severity of wheezing in MPP children,and to analyze the possible risk factors for wheezing in MPP children.Meanwhile,the role of VitD and TGF-beta 1 in MPP children with wheezing with airway inflammation and airway remodeling was analyzed by measuring the levels of TGF-beta 1,lung function and exhaled NO concentration in some children with MPP.Results:The serum 25(OH)D level in MPP with wheezing group was significantly lower than that in MPP without wheezing group(38.29±14.95ng/ml)and control group(36.95±7.27ng/ml)(P<0.05).There was no significant difference in 25(OH)D level between MPP without wheezing group and control group(P>0.05).The proportion of VitD deficiency/deficiency in MPP with wheezing group(53.1%)was significantly higher than that in MPP without wheezing group(28.6%)and control group(15.0%).The ratio of VitD deficiency/deficiency in MPP without wheezing group was significantly higher than that in control group(P<0.05).There were no significant differences in hs-CRP,PCT,Ca,P and immunoglobulin between MPP with wheezing group and MPP without wheezing group(P>0.05);the age of VitD deficiency/deficiency group(5.06±3.02 years),hs-CRP level(9.29±8.88 mg/L)and the incidence of wheezing(68.0%)in MPP with wheezing group were significantly higher than those in VitD normal group(2.44±1.49 years,4.41±4.15 mg/L,42.9%),the difference was statistically significant(P<0.05).Serum 25(OH)D level was negatively correlated with age(R~2=0.277,P=0.000),hs-CRP(R~2=0.150,P=0.003)and IgA(R~2=0.296,P=0.020).The level of TGF-beta 1 in MPP with wheezing group was significantly higher than that in MPP without wheezing group(0.77±0.33 ng/ml)and control group(0.73±0.18 ng/ml)(P<0.05).There was no significant difference in the level of TGF-beta 1 between MPP without wheezing group and control group(P>0.05).There was a negative correlation trend between serum TGF-beta 1 level and 25(OH)-D level in children with MPP,but the trend was not statistically significant(P>0.05).No correlation was found between serum 25(OH)D and TGF-beta 1 levels and pulmonary hypofunction and exhaled NO concentration.Conclusions:1.The serum level of 25(OH)D in MPP with wheezing group was significantly lower than that in MPP without wheezing group and control group,and the proportion of VitD deficiency/deficiency was higher in MPP with wheezing group.2.Decreased serum 25(OH)D level is one of the risk factors for wheezing in children with MPP,which is related to the severity of inflammation.3.Serum 25(OH)D level in MPP children was negatively correlated with age,suggesting that more attention should be paid to VitD supplementation in older children.4.The serum levels of TGF-beta 1 in MPP with wheezing group were significantly higher than those in MPP without wheezing group and control group.The serum levels of 25(OH)D and TGF-beta 1 in MPP patients showed a negative correlation trend,suggesting that the decrease of 25(OH)D may be associated with the increase of TGF-beta 1 in early airway remodeling. |
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