| PART Ⅰ Serum25-hydroxy VitaminD3levels in infants with bronchiolitisand the relationship with feedingObjective:To explore the relationship between serum25-hydroxy VitaminD3Level andbronchiolitis by detecting the serum25-hydroxy VitaminD3Level in infants withbronchiolitis,and to discuss the influence of different feeding ways to serum25-hydroxyVitaminD3Level and the course of disease.Methods：Chooseing63cases of infants with bronchiolitis in respiration ward as bronchiolitisgroup.The bronchiolitis group were divided into breast-feeding,the part of thebreastfeeding and artificial feeding according to different feeding ways within fourmonths.Chooseing50noninfectious infants in surgical ward in our hospital in the sameperiod as control group.The infants of the control group had no wheezeing history,noallergic disease history and no allergic family history,also had no active rickets history.Allof them were taken hollow venous blood2ml the day they hospitalized beforetreatment.Detecting the serum25-hydroxy VitaminD3Level by Enzyme-linkedimmunoadsordent assay.Collate and analyse the above data by statistical softwareSPSS17.0and got conclusions.Results：1. Bronchiolitis group serum25-hydroxy VitaminD3levels compared with the controlgroupThe serum25-hydroxy VitaminD3levels of bronchiolitis group（55.18±18.87）nmol/L were significantly lower than the control group（67.75±28.44）nmol/L.There was significant difference in statistics,t value was-2.69,P value was0.009,<0.01.2. The proportion of the lack of serum25-hydroxy VitaminD3(<50nmol/L),vitaminD3deficiency(50-75nmol/L) and normal (>75nmol/L) in bronchiolitis group and controlgroup（1）In bronchiolitis group,there were18cases with the lack of serum25-hydroxyVitaminD3,accounted for28.57%.36cases of the serum25-hydroxy VitaminD3deficiency,accounted for57.14%.9cases were normal,accounted for14.28%.（2）In control group,there were13cases with the lack of serum25-hydroxyVitaminD3,accounted for26%.13cases of the serum25-hydroxy VitaminD3deficiency,accounted for26%.24cases were normal,accounted for48%.（3）There was significant difference in statistics of the proportion between thebronchiolitis group and the control group,the chi-square value was17.15,P<0.01.3. In bronchiolitis group,the comparison of the course of disease among the lack ofserum25-hydroxy VitaminD3,vitamin D3deficiency and normal（1）The course of serum25-hydroxy VitaminD3normal group（6.89±1.45days）was shorter than the lack of serum25-hydroxy VitaminD3group（9.11±1.74days）andvitamin D3deficiency group（8.67±1.58days）,there was significant difference instatistics,t value was-3.28and-3.05,P<0.01.（2）There was no significant difference in statistics of the course between the lack ofserum25-hydroxy VitaminD3group and the vitamin D3deficiency group, t value was0.93,P value was0.35,>0.05.4.In bronchiolitis group,the serum25-hydroxy VitaminD3levels of breast-feedinginfants, the part of the breastfeeding infants and artificial feeding infants（1）The serum25-hydroxy VitaminD3levels of breast-feeding infants（48.13±23.35）nmol/L were lower than the part of the breastfeeding infants（58.92±11.41）nmol/Land artificial feeding infants（64.43±12.70）nmol/L.There was difference in statistics,tvalue were-2.18and-3.15,P value were0.03and0.003,<0.05.（2）There was no difference in statistics between the part of the breastfeeding infantsand artificial feeding infants,t value was-1.31,P value was0.199,P>0.05.5. In bronchiolitis group,the proportion of the lack of serum25-hydroxy VitaminD3(<50nmol/L),vitamin D3deficiency(50-75nmol/L) and normal (>75nmol/L) inbreast-feeding infants,the part of the breastfeeding infants and artificial feeding infants（1）Breast-feeding infants included30cases, there were13cases with the lack of serum25-hydroxy VitaminD3,accounted for43.33%.13cases of the serum25-hydroxyVitaminD3deficiency,accounted for43.33%.4cases normal,accounted for13.33%.（2）The part of the breastfeeding infants included17cases,there were6cases withthe lack of serum25-hydroxy VitaminD3,accounted for35.29%.10cases of the serum25-hydroxy VitaminD3deficiency accounted for58.82%.1case was normal,accounted for5.88%.（3）Artificial feeding infants included16cases,there was1case with the lack ofserum25-hydroxy VitaminD3,accounted for6.25%.11cases of the serum25-hydroxyVitaminD3deficiency accounted for68.75%.4cases were normal,accounted for25%.（4）There was no significant difference in statistics of the proportion among the threefeeding ways,the chi-square value was8.10,P value was0.08,>0.05.6. The comparison of the course of disease among breast-feeding group,the part of thebreastfeeding group and artificial feeding group（1）The course of breast-feeding group（7.90±1.37days）was shorter than the othertwo groups（8.88±1.78and9.35±1.93days）,t value were-2.064and-2.99,P value were0.045and0.004,there was difference in statistics.（2）There was no significant difference in statistics of the course of the part of thebreastfeeding group and artificial feeding group, t value was-0.736,P value was0.46,>0.05.Conclusion:1.The serum25-hydroxy VitaminD3levels of bronchiolitis group were significantlylower than the control group.2. In the bronchiolitis group,the course of disease in the lack of serum25-hydroxyVitaminD3and vitamin D3deficiency infants were longer than the normal infants.3.In the bronchiolitis group,the serum25-hydroxy VitaminD3levels of breast-feedinginfants were significantly lower than the artificial feeding infants,were lower than the partof the breastfeeding infants.4.The course of disease in breast-feeding group were shorter than the other twogroups. PART Ⅱ The study of urine leukotriene E4levels in infants with bronchiolitisafter VitaminD3interventionObjective:1.To confirm the urine leukotriene E4is an inflammatory mediator of bronchiolitis bydetecting the urine leukotriene E4level in infants with bronchiolitis.2.To discuss the effect of VitaminD3to the secondary prevention of asthma bydetecting the urine leukotriene E4levels in infants with bronchiolitis after VitaminD3intervention.Methods:Chooseing90infants diagnosed bronchiolitis in respiration ward as bronchiolitisgroup.All of them were atopic constitution (had eczema or atopic dermatitis) and weregiven conventional treatment (inhaled Budesonide and Compound Ipratropium BromideSolution,Montelukast,antiviral therapy,symptomatic treatment and so on).The90caseswere randomly divided into two groups after clinical symptom remission.VitaminD3（400IU per day）was given to the VitaminD3intervention group.The black control groupwas given no intervention.Follow-up six months. Chooseing56infants in surgical in ourhospital with noninfectious in the same period as control group.The infants of the controlgroup had no wheezing history,no allergic disease history and no allergic familyhistory.The bronchiolitis group were taken morning urine10ml respectively in the acutewheezeing stage(the day they were hospitalized),the remission stage(before VitaminD3intervention) and after VitaminD3intervention.Put2ml in-70℃refrigerator storage todetect the urine leukotriene E4（pg/ml）,8ml to detect urine creatinine(μmol/L).The controlgroup were taken morning urine10ml the day they were hospitalized.Put2ml in-70℃refrigerator storage to detect the urine leukotriene E4,8ml to detect urine creatinine.Thefinally result was the urine leukotriene E4divided by the urine creatinine（×103pg/μmol）.Collate and analyse the above data by statistical software SPSS17.0andgot conclusions.Results:1.Bronchiolitis group urine leukotriene E4levels in the acute wheezeing stage and the remission stage compared with the control group（1）There was significant difference in statistics of the urine leukotriene E4levelsbetween the acute wheezeing stage of bronchiolitis group（6.18±1.26）×103pg/μmol andthe control group（3.31±0.60）×103pg/μmol,t value was15.938,P <0.01.（2）The urine leukotriene E4levels in the remission stage（3.66±0.77）×103pg/μmolwere lower than the acute wheezeing stage,there was significant difference,t value was-16.198,P<0.01.（3）There was significant difference of the urine leukotriene E4levels between theremission stage of bronchiolitis group and the control group,t value was2.877,P value was0.005,<0.01.2.The urine leukotriene E4levels of VitaminD3intervention group and the blankcontrol group（1）The two groups are comparable before intervention and has no statisticaldifference,t value was1.87,P value was0.065,>0.05.（2）In the VitaminD3intervention group,the urine leukotriene E4levels afterVitaminD3intervention （3.36±0.61）×103pg/μmol were lower than beforeintervention,there was significant statistical difference,t value was–2.815,P value was0.006,<0.01.（3）In the blank control group，the urine leukotriene E4levels after six months（3.27±0.39）×103pg/μmol were descend, there was statistical difference,t value was–2.11,Pvalue was0.037,<0.05.（4）There was no statistical difference of the urine leukotriene E4levels betweenVitaminD3intervention group and the blank control group after VitaminD3intervention,tvalue was0.83,P value was0.408,>0.05.3.The comparison of the cases of wheezeing recurrence within six months betweenVitaminD3intervention group and the blank control group.VitaminD3intervention group had three cases and the blank control group had fivecases of wheezeing recurrence.There was no statistical difference of the cases ofwheezeing recurrence between the two groups,the chi-square value was0.549,P value was0.459,>0.05. Conclusion:1.The urine leukotriene E4levels of bronchiolitis group were significantlyincreased,especially in the acute wheezeing stage.The urine leukotriene E4levels inremission stage were lower than in acute wheezeing stage,but higher than the controlgroup.2.The urine leukotriene E4levels in VitaminD3intervention group after interventionwere lower than before intervention,but there was no statistical difference between theVitaminD3intervention group and the black control group.So,the VitaminD3can notdecrease the urine leukotriene E4.3.The effect of VitaminD3on the secondary prevention of asthma still need moreevidence. |
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