Study On The Relationship Between Vitamin A And Humoral Immune,clinical Outcome In Children With Severe Pneumonia

Objective: To provide new ideas for comprehensive treatment of severe pneumonia by explore the effect of vitamin A(VA)on humoral immune function and clinical outcome in children with severe pneumonia.Methods: 300 children with severe pneumonia from May 2017 to June 2018 in pediatric intensive care unit(PICU)were included in the study.Blood samples were collected on the first day of admission before using antibiotics and antivirals.To make multiple regression analysis between the level of VA and the level of humoral immunity which include IgA,IgM and IgG in children with severe pneumonia,by detecting the level of serum VA using High Performance Liquid Chromatography and the level of humoral immunity using rate nephelometry.105 children with severe pneumonia and VA deficiency were randomly divided into treatment group and control group,the treatment group was given conventional therapy and VA Intervention therapy,the control group was given conventional therapy.To observe the effect of VA intervention on the clinical outcome of children with severe pneumonia,by the prospective comparative study on the level of serum VA,the number of days in PICU,the average total hospitalization days and the total effective rate of treatment of the two treatments.Results:(1)The children with subclinical suspected lack of VA accounted for 24.30%(73/300)and subclinical deficiency of VA accounted for 35.00%(105/300)in the study.(2)The regression coefficients of VA level and IgA,IgM in children with severe pneumonia were 1.40,2.23(P<0.05).The regression coefficients of VA level and IgG in severe pneumonia children under and above 4 months old were 14.56,13.03(P<0.05).(3)The levels of VA in treatment group and control group were(0.14�0.03)mg/L and(0.14�0.04)mg/L at admission,there was no significant difference between the two groups(P>0.05).The levels of VA in treatment group and control group were(0.25�0.03)mg/L and(0.15�0.04)mg/L at discharged,the level of serum VA in the control group was significantly lower than that in the treatment group,and the difference was statistically significant(P<0.05).(4)The number of days in PICU and the average total hospitalization days were(3.09�0.56)d and(9.58�0.77)d in the treatment group,which were(4.65�0.79)d and(11.63�1.16)d in the control group.The number of days in PICU and the average total hospitalization days in the treatment group were shorter than those in the control group,and the difference was statistically significant(P<0.05).(5)The total effective rate was 96.23% in the treatment group and 94.23% in the control group.There was no significant difference between the two groups(P>0.05).Conclusion: Children with severe pneumonia were generally deficient in VA in the study.The children with deficient VA were more likely to develop severe pneumonia.The level of VA in children with severe pneumonia had a significant linear relationship and a positive correlation with the levels of IgA,IgM and IgG.VA deficiency can affect the prognosis time,and the adjuvant treatment of VA intervention can be used as one of the comprehensive treatment measures for children with severe pneumonia.