| Objective:By retrospectively analyzing the clinical data of children with Mycoplasma pneumoniae pneumonia(MPP)with wheezing and children with MPP without wheezing,we investigated the relationship between 25-hydroxyvitamin D[25-hydroxyvitamin D,25(OH)D] levels and children with MPP with wheezing,and clarified its effect in To investigate how vitamin D(Vitamin D,Vit D)affects wheezing in children with MPP,and to provide a new basis for early identification and prevention of wheezing diseases in children.Methods:In this study,89 children with MPP who were hospitalized in our pediatric department from October 2021 to January 2022 were selected as the observation group,and children with MPP were divided into group 1(with wheezing group)and group 2(without wheezing group)by auscultating the lungs and grouping them according to whether the doctor could hear croup during auscultation.Thirty-six healthy children with matching age and gender were selected as the healthy control group.Through retrospective review of the hospital’s electronic medical record system,general clinical information on children with MPP was collected: age,gender,Body Mass Index(BMI)and other clinical tests: 25(OH)D,Procalcitonin(PCT),High-sensitivity c-reactive protein(hs-CRP),white blood cell count(WBC),neutrophil-lymphocyte absolute value ratio(NLR),alkaline phosphatase(ALP),and other clinical tests: 25(OH)D,procalcitonin(PCT),high sensitivity-C reactive protein(hs CRP),white blood cell count(WBC),and neutrophil-lymphocyte absolute value ratio(NLR).Alkaline phosphatase(ALP),lactic dehydrogenase(LDH),creatine kinase isoenzyme(CK-MB),prealbumin(PA)blood calcium,blood phosphorus,etc.Clinical data were collected from healthy controls: age,sex,25(OH)D levels.To analyze the differences in the clinical data of group 1 and group 2,to compare the serum 25(OH)D levels of children in group 1,group 2 and healthy controls and to analyze the Vit D abnormalities in each group;Children in the observation group were divided into groups of 0 to 3 years old(0 years < age < 3 years old)and 3 to 5 years old(3 years ≤ age ≤ 5 years old)and > 5 years old(age > 5 years old)according to their age,and the serum 25(OH)D levels and Vit D abnormalities of children in the three groups were compared;According to 25(OH)D levels,children with MPP were divided into two groups: group A(Vit D deficient/insufficient group)and group B(Vit D normal group),and the clinical data and the incidence of wheezing in the two groups were analyzed and compared;the correlation between serum 25(OH)D levels and other clinical indicators in children with MPP was analyzed.The data were analyzed using SPSS26.0 statistical software.Results:1.The differences in PCT,hs-CRP,WBC,NLR,ALP,LDH,CK-MB,PA,blood calcium,and blood phosphorus between children in group 1 and group 2 were not statistically significant(all P > 0.05).2.Serum 25(OH)D levels in group 1,group 2 and healthy controls: 25(OH)D)levels in group 1 [30.25(24.17,33.95)ng/ml] were significantly lower than those in group 2[33.80(28.60,39.10)ng/ml] and healthy controls [35.05(24.20,39.50)ng/ml](all P <0.05);25(OH)D levels were not statistically different between group 2 and healthy controls(P > 0.05);the ratio of Vit D deficiency/insufficiency was 50.0%,29.8%,and 19.4% in group 1,group 2,and healthy controls,respectively,and the difference in this ratio between group 1 and healthy controls was statistically significant(P < 0.05),and the ratio between group 2 and group 1 and healthy controls was not There was no statistical difference between group 2 and group 1 and healthy control group(P > 0.05).3.Comparing the serum 25(OH)D levels of children in the observation groups after grouping them according to different ages,the results showed that the serum 25(OH)D levels in the 0 to 3 years old group,the 3 to 5 years old group,and the >5 years old group were(34.60 ± 4.96)ng/ml,(33.03 ± 7.52)ng/ml,and(31.59 ± 7.43)ng/ml,respectively.children in the >5 years old group Serum 25(OH)D levels were significantly lower than those in the 0-to 3-year-old group(P <0.001)and the 3-to 5-year-old group(P=0.009),and there was no statistically significant difference between the 0-to 3-year-old group and the 3-to 5-year-old group when comparing children’s serum 25(OH)D(P=0.711);the percentages of Vit D deficiency/insufficiency in children in the 0-to 3-year-old group,the3-to 5-year-old group,and the >5-year-old group were 14.3%、41.0%、55.2% respectively.This ratio was statistically different between the 0-to 3-year-old group and the >5-year-old group(P<0.05),and not statistically different between the children in the 3-to 5-year-old group and the 0-to 3-year-old and >5-year-old groups(P>0.05).4.Comparing the clinical test data and the incidence of wheezing in group A and group B: the age of children in group A(5.46±2.18)was significantly higher than that in group B(3.93±2.04),and the hs CRP level in group A [8.01(4.14,10.66)mg/L] was significantly higher than that in group B [3.78(0.91,7.96)mg/L],and all these differences were statistically significant(all P<0.05),while gender,BMI,PCT,WBC,NLR,ALP,LDH,CK-MB,PA,blood calcium,and blood phosphorus were not statistically different in the two groups(P>0.05);the incidence of wheezing was higher in group A(60.0%)than in group B(38.9%),and the difference was not statistically significant(P>0.05).5.The correlation between 25(OH)D and other indices in children in the observation group was compared: it was found to be negatively correlated with age and hs CRP(all P<0.05)and not correlated with BMI,ALP,PA,CK-MB,LDH,blood calcium and blood phosphorus(all P>0.05).Conclusions:1.Children with MPP with wheezing had reduced serum 25(OH)D levels compared to children with MPP without wheezing and healthy children,and had a higher proportion of Vit D deficiency/insufficiency than the latter two groups.2.In children with MPP,serum 25(OH)D levels were negatively correlated with age,and serum 25(OH)D levels were significantly lower in children aged >5 years than in other groups,suggesting that parents and health workers should pay attention to Vit D deficiency in children aged >5 years and provide Vit D supplementation in a timely manner.3.Among children with MPP,serum hs CRP levels and the incidence of wheezing were higher in children with Vit D deficiency/insufficiency than in children with normal Vit D,suggesting a correlation between Vit D and inflammatory response and wheezing. |
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