Correlation Between Serum Zinc And Vitamin A?D Levels And Repeated Upper Respiratory Tract Infections And Their Regulatory Mechanisms

Objective: To explore the risk factors of recurrent upper respiratory tract infection in children,and to further clarify its regulatory mechanism by analyzing the correlation between serum zinc,vitamin A?vitamin D and the level of cellular immunity,humoral immunity and inflammatory factors in patients.Methods:1.From February 2017 to December 2019,92 cases of recurrent upper respiratory tract infection aged 3-5 years were selected as the case group,100 children aged 3-5 years without recurrent upper respiratory tract infection were randomly selected as the control group,and 120 children aged 3-5 years were selected as the health group.2.Logistic regression was used to analyze the factors of recurrent upper respiratory tract infection in children.Serum levels of zinc,vitamin A,vitamin D,interleukin-6,serum CRP,procalcitonin,Ig G,Ig M,Ig A,complement 3(C3)and complement 4(C4)were detected,the number of peripheral blood CD4?CD8?Th1?Th2?Th17?CD4CD25(treg)t lymphocyte subsets was analyzed by flow cytometry to calculate the Th1/Th2,Th17/Treg ratio.Pearson correlation was analyzed between serum zinc,vitamin A?vitamin D level and CD4?CD8?Treg?Th1/Th2?Th17/Treg ratio,serum CRP?IL-6.Compare the difference of each index between case group,control group and health group.To analyze the correlation between serum zinc,vitamin A?vitamin D level and recurrent upper respiratory tract infection,and to use the working characteristic curve of the subjects to analyze the clinical early warning significance of increasing the ratio of Th1/Th2?Th17/Treg to recurrent upper respiratory tract infection.Results:1.The analysis showed that the serum zinc,vitamin A? vitamin D levels of each group were compared,the difference between the case group and the other two groups was statistically significant(P<0.05),and there was no significant difference between the control group and the healthy group(P>0.05).2.The ratio of peripheral blood Th1?Th2?Th17?Th1/Th2?Th17/Treg was statistically significant(P<0.05).but there was no significant difference in the number of CD4 ? CD8 ? CD4CD25(treg)(P>0.05).and there was no significant difference between the control group and the healthy group(P>0.05).3.The serum Ig G?Ig M?Ig A level of the children in the case group was significantly lower than that in the other two groups(P<0.05),but there was no significant difference in the C3?C4 level(P>0.05).Compared with the healthy group,there was no significant difference in each index(P>0.05).4.The serum IL-6?CRP level of the children in the case group and the control group increased significantly compared with the healthy group(P<0.05).but there was no significant difference between the case group and the control group(P>0.05).and there was no significant difference between the two groups of serum procalcitonin levels(P>0.05).5.Serum zinc,vitamin A?vitamin D levels were significantly negatively correlated with recurrent upper respiratory tract infections(r=-0.467;-0.491;-0.548,P<0.05).there was a positive correlation between serum zinc,vitamin A?vitamin D and Th1/Th2 ratio(r=0.653;0.674;0.601,P<0.05),and there was a negative correlation between serum zinc,vitamin,and serum CRP?IL-6?levels(0.05).Th1/Th2?Th17/Treg Proportion of Patients with Recurrent Upper Respiratory Infection product AUC= under the curve(0.704,0.685).taken Th1/Th2?0.93 as the cut-off value,the diagnostic sensitivity was 82.46% and the specificity was 89.99%.taken Th17/Treg?0.91 as the cut-off value,the diagnostic sensitivity was 83.21% and the specificity was 86.89%.Conclusion:1.The decrease D serum zinc,vitamins A?vitamins is a risk factor for recurrent upper respiratory tract infections.2.The occurrence of recurrent upper respiratory tract infection involves many factors,such as immunity,serum inflammatory reaction,trace elements and vitamin deficiency in children.the decrease in serum zinc,vitamin A?vitamin D levels is associated with the imbalance of immune inflammatory response regulation in children with repeated upper respiratory tract infections.serum zinc,vitamin A?vitamin D levels were significantly negatively correlated with the occurrence of recurrent upper respiratory tract infections,positively correlated with Th1/Th2 ratios,and negatively correlated with Th17/Treg ratios and serum CRP?IL-6levels.3.Detection of Th1/Th2?Th17/Treg proportion level is helpful for the diagnosis of children with recurrent upper respiratory tract infection.