| 摘要: |
| 目的：探讨过敏性紫癜（HSP）患儿血清25-羟维生素D[25-（OH）D]和维生素D抗体水平变化及意义。方法：选取2017年7月至2019年1月南阳市第一人民医院儿科收治的HSP患儿73例。根据是否合并紫癜性肾炎（HSPN）分为合并紫癜性肾炎的HSPN组（n=32）和未合并紫癜性肾炎的HSP组（n=41）；根据不同临床症状表现分为单纯组（n=15）、关节症状组（n=17）、消化道症状组（n=14）及混合症状组（n=27）。选取同期41例体检正常健康儿童作为健康对照组。采用酶联免疫吸附法检测血清25-（OH）D水平和维生素D抗体水平，比较各组患儿血清25-（OH）D水平和维生素D抗体水平变化情况。结果：HSP组患儿血清25-（OH）D水平显著低于健康对照组（P<0.05），HSPN组患儿血清25-（OH）D水平低于HSP组和健康对照组（P<0.05）。HSP组和HSPN组血清维生素D抗体水平均高于健康对照组（P<0.05）。HSPN组患儿维生素D抗体水平与HSP组比较差异无统计学意义（P>0.05）。关节症状组、消化道症状组、混合症状组的25-（OH）D水平均低于单纯组（P<0.05），但关节症状组、消化道症状组、混合症状组的25-（OH）D水平比较差异无统计学意义（P>0.05）。不同症状组的HSP患儿维生素D抗体水平比较差异无统计学意义（P>0.05）。结论：HSP患儿体内25-（OH）D水平较低，尤其是伴有其他症状的HSP患儿25-（OH）D水平更低。HSP患儿维生素D抗体水平高于健康儿童，但不同症状HSP患儿维生素D抗体水平并无差异，因此不同症状HSP患儿25-（OH）D缺乏程度可能与皮肤、肾脏、胃肠道等受累致维生素D合成不足和吸收不良有关。 |
| 关键词: 过敏性紫癜 25-羟-维生素D 维生素D抗体 |
| DOI：doi:10.13407/j.cnki.jpp.1672-108X.2020.06.002 |
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| 基金项目: |
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| Changes and Significance of Serum Levels of 25-Hydroxy Vitamin D and Vitamin D Antibody in Children with Henoch-Schönlein Purpura |
| Song Qingmei, Zhang Xiao, Xu Rui |
| (Nanyang First People’s Hospital, Henan Nanyang 473000, China) |
| Abstract: |
| Objective: To probe into the changes and clinical significance of serum levels of 25-hydroxy vitamin D (25-(OH)D) and vitamin D antibody in children with Henoch-Schönlein purpura (HSP). Methods: Seventy-three children with HSP admitted to pediatrics of Nanyang the First People’s Hospital from Jul. 2017 to Jan. 2019 were extracted as the research objectives. According to whether the children were complicated with Henoch-Schönlein purpura nephritis (HSPN), all children were divided into the HSPN group (n=32) and the HSP group (n=41). According to different clinical symptoms, all children were divided into the simple group (n=15), the joint symptom group (n=17), the gastrointestinal symptom group (n=4) and the mixed symptom group (n=27). Forty-one healthy children with normal physical examination in the same period were selected as the control group. Serum levels of 25-(OH)D and vitamin D antibody were detected by enzyme linked immunosorbent assay (ELISA). Changes of serum levels of 25-(OH)D and vitamin D antibody in each group were compared and analyzed. Results: The serum levels of 25-(OH)D in the HSP group were significantly lower than those in the control group (P<0.05), and the serum levels of 25-(OH)D in the HSPN group were significantly lower than those in the HSP group and the control group (P<0.05). The serum levels of vitamin D antibody in the HSP group and HSPN group were higher than those in the control group (P<0.05). There was no significant difference in the levels of vitamin D antibody between the HSPN group and the HSP group (P>0.05). The levels of 25-(OH)D in the joint symptom group, the gastrointestinal symptom group and the mixed symptom group were lower than those in the simple group (P<0.05), yet the differences in the levels of 25-(OH)D in the joint symptom group, the gastrointestinal symptom group and the mixed symptom group were not statistically significant (P>0.05). There was no significant difference in the levels of vitamin D antibody in children with HSP in different symptom groups (P>0.05). Conclusion: The levels of 25-(OH)D are relatively low in children with HSP, especially those with different symptoms. The levels of vitamin D antibody in children with HSP are significantly higher than those in normal healthy children. However, there is no statistical difference in the levels of vitamin D antibody in children with different symptoms. Therefore, the deficiency of 25-(OH)D in children with different symptoms of HSP may be related to the deficiency of vitamin D synthesis and malabsorption caused by impaired degree of skin, kidney and gastrointestinal tract. |
| Key words: Henoch-Schönlein purpura, 25- hydroxy vitamin D, vitamin D antibody |
