| Objective :By detecting serum vitamin A and D levels and immune function indexes of children aged 0-7 years old with recurrent respiratory tract infections(RRTIs)and normal children of the same age,and comparing the differences between the two groups,we could understand the correlation between serum vitamin A,D levels and immune function and the occurrence of recurrent respiratory tract infections in children.It provides a basis for vitamin A and D supplementation and immune function monitoring in children aged 0-7 years with recurrent respiratory infections.Methods:Using the case-control study method,57 children aged 0-7 who met the diagnostic criteria for recurrent respiratory tract infections admitted to the pediatric ward of the Second Affiliated Hospital of Kunming Medical University from June 2019 to December 2021 were selected as the observation group.In addition,68 children aged0-7 years old were selected as the control group.The two groups of children were divided into three groups according to age: 0-1,-3,-7 years old,and the serum vitamin A and D levels and immune function indexes of the two groups were respectively detected.The differences in serum vitamin A and D levels of different ages between the two groups were compared.The correlation between serum vitamin A and D levels and immune function in children with RRTIs was analyzed.The effects of serum vitamin A and D levels and immune function indicators on RRTIs were analyzed.Serum vitamin A levels were detected by high performance liquid chromatography,serum 25-(OH)D levels by chemiluminescence immunoassay,immunoglobulins by immunoscattering turbidimetry,and T lymphocyte subsets by flow cytometry fluorescent staining labeling.Statistics uses SPSS22.0 statistical software to perform statistical analysis on the data.Results:1.Among the 57 children in the observation group,31 were male and 26 were female,with an average age of 3.474±2.053 years;Among the 68 children in the control group,38 were males and 30 were females,with an average age of4.082±1.699 years.There were no significant differences in age and sex between the observation group and the control group,and the P values were 0.867 and 0.072,respectively.2.The serum vitamin A level in the observation group was 0.27±0.13mg/L,and the control group was 0.45±0.16mg/L,and the serum vitamin A level in the observation group was lower than that in the control group,the difference was statistically significant,and the P value was less than 0.001.The serum level of25-(OH)D in the observation group was 68.15±25.02 ng/m L,and the control group was 83.16±19.95 ng/m L,and the serum 25-(OH)D level in the observation group was lower than that in the control group,and the P value was less than 0.001.3.Among the 57 children in the observation group,11 cases had normal serum vitamin A levels,accounting for 19.3%;There were 28 cases of borderline deficiency,accounting for 49.1%;There were 18 cases of deficiency,accounting for 31.6%.Among the 68 children in the control group,54 had normal serum vitamin A levels,accounting for 79.4%;There were 13 cases of subclinical deficiency,accounting for19.1%;There was 1 case of deficiency,accounting for 1.5%.The difference between the two groups of children with normal serum vitamin A,borderline deficiency and the number of deficiencies was statistically significant,and the P value was less than0.001.4.The serum vitamin A levels of children aged 0-1,-3 years and-7 years old in the observation group were not statistically significant,and the P value was greater than 0.05;the serum vitamin A level of children in the control group was not statistically significant,and the P value was greater than 0.05.However,the serum vitamin A levels of children aged 0-1,-3 and-7 years in the observation group were lower than those in the control group,and the serum vitamin A levels of children in the observation group and the control group were statistically significant,and the P value was less than 0.05.The serum 25-(OH)D levels of children aged 0-1 years,-3 years and-7 years old in the observation group were lower than those in the control group,but the difference in serum 25-(OH)D levels between the observation group and the control group was statistically significant,and the P value was less than 0.05;the difference in serum25-(OH)D levels between the observation group and the control group was not statistically significant,and the P value was greater than 0.05.5.The mean values of IgG,IgA and IgM in the observation group were7.81±2.69g/L,0.80±0.51g/L and 1.12±0.59g/L,respectively.The mean values of IgG,IgA and IgM in the control group were 9.07±2.27g/L,1.31±1.22g/L and 1.33±0.01g/L,respectively.The levels of IgG,IgA and IgM in humoral immunity in the observation group were lower than those in the control group,and the differences in IgG and IgA levels were statistically significant,with P values of 0.005 and 0.004,respectively,and the difference in IgM levels was not statistically significant,and the P value was0.053.The mean values of CD3+,CD4+,CD8+ and CD4+/CD8+ in the observation group were 60.52±12.62%,30.68±8.47%,23.23±7.71% and 1.58±0.60%,respectively.The mean values of CD3+,CD4+,CD8+ and CD4+/CD8+ in the control group were66.50±11.07%,36.13±8.57%,28.55±7.27% and 1.85±0.45%,respectively.The levels of CD3+,CD4+,CD8+,CD4+/CD8+ in the observation group were lower than those in the control group,and the P values were 0.006,0.001,less than 0.001,and P=0.006,respectively.6.Serum vitamin A,25-(OH)D,IgA,CD4+,CD8+,CD4+/CD8+ were reduced as risk factors for the development of RRTIs(P values were less than 0.05 or less than0.001).7.Serum vitamin A levels in children with RRTIs were positively correlated with IgG,IgA and IgM levels(P<0.001,P<0.001,P=0.035);There was an inverse correlation with CD4+/CD8+ levels(P=0.018);There was no correlation with CD3+,CD4+,CD8+ levels(P=0.072,P=0.946,P=0.062).The serum 25-(OH)D level of RRTIs was positively correlated with the levels of IgG,IgA,IgM,CD3+ and CD8+(P<0.001,P<0.001,P=0.004,P=0.014,P=0.034).There was a negative correlation with CD4+/CD8+ levels(P=0.010);There was no correlation with CD4+ levels(P=0.691).Conclusions:1.The borderline deficiency and deficiency rate of serum vitamin A level in children with RRTIs was 80.7%;The rate of serum 25-(OH)D insufficiency and deficiency was 59.7%.2.The mean serum vitamin A and 25-(OH)D values of children with RRTIs of all ages were lower than those of healthy children aged 0-1 years,-3 years old and-7 years old.3.The levels of humoral immunity and cellular immunity in children with RRTIs were lower than those in the control group.4.Serum vitamin A,25-(OH)D,IgA,CD4+,CD8+,CD4+/CD8+ are risk factors for the development of RRTIs.5.The serum vitamin A level of children with RRTIs was positively correlated with the levels of IgG,IgA and IgM;Serum 25-(OH)D levels were positively correlated with IgG,IgA,IgM,CD3+,CD8+ levels. |
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