兒童維生素A水平與百日咳桿菌感染的關系

傅雯靜 鄧鏡業

[關鍵詞] 維生素A;百日咳;兒童;痙攣性咳嗽

[中圖分類號] R179? ? ? ? ? [文獻標識碼] B? ? ? ? ? [文章編號] 1673-9701（2021）25-0070-04

Relationship between vitamin A level and bacillus pertussis infection in children

FU Wenjing? ?DENG Jingye

Department of Pediatrics，Jiangmen Central Hospital/Jiangmen Hospital Affiliated to Sun Yat-sen University，Jiangmen，? 529000

[Abstract] Objective To investigate the relationship between the Vitamin A level and bacillus pertussis infection in children to provide guidance for clinical diagnosis and treatment. Methods A total of 250 children aged 0-13 years who were hospitalized in the Department of Pediatric Internal Medicine in our hospital from December，2017 to December，2019 with spasmodic cough as the main symptom were selected. According to the nucleic acid and pharyngeal swab polymerase chain reaction （PCR） results of pertussis，the patients were divided into two groups： the pertussis positive group （n=73） and the pertussis negative group （n=177）. Blood levels of Vitamin A were determined by the high performance liquid chromatography （HPLC）. The relationships between subclinical Vitamin A deficiency，suspected subclinical Vitamin A deficiency，and normal Vitamin A in children and Bacillus pertussis infection were analyzed and compared. Results The relationships between subclinical Vitamin A deficiency，suspected subclinical Vitamin A deficiency，and normal Vitamin A in children and Bacillus pertussis infection were analyzed and compared. In the pertussis infection group，19 patients （26.03%） with SVAD （subclinical Vitamin A deficiency），24 patients（32.88%）? with SSVAD （suspicious subclinical Vitamin A deficiency） and 30patients（41.10%） with normal VA （Vitamin A） were found. In the non-pertussis group，13 patients（7.34%） with SVAD，32 patients（18.08%） with SSVAD，and 132 patients（74.58%） with normal VA were found. The incidences of SVAD and SSVAD in the pertussis positive group were higher than those in the pertussis negative group （P<0.05），and the VA reserve sufficiency rate in the pertussis negative group was higher than that in the pertussis positive group （P<0.05）. Conclusion Clinical and subclinical Vitamin A deficiency may be associated with pertussis infection in children.

[Key words] Vitamin A; Pertussis; Children; Spasmodic cough

維生素A又明視黃醇，為脂溶性維生素，主要生理功能為維持正常的生長、生殖、視覺、上皮組織健全及抗感染免疫功能。維生素A對上皮組織的形成、發育和維持健全十分重要，影響上皮細胞黏膜中糖蛋白的合成，促其形成正常結構，缺乏時上皮組織結構受損，呼吸道、消化道、泌尿生殖道、消化道系統內膜上皮細胞受損容易發生感染[1]。維生素A缺乏（Vitamin A deficiency，VAD）是目前世界衛生組織確認的世界四大營養缺乏病之一，是21世紀末需要被重點解決的兒童健康問題[2]。百日咳為百日咳鮑特氏桿菌引起的急性呼吸道傳染病。其特點為陣發性痙攣性咳嗽，且病程可長達數月[3]。由于疫苗的廣泛接種，我國百日咳的流行已大大減少，發病率、病死率也明顯降低。但是近年來，世界各地報道百日咳的發病情況有上升的趨勢。特別在青少年人群，由于癥狀的不典型，實際感染人數可能比報道的要多[4]。由于百日咳感染的病程長，癥狀嚴重，對青少年兒童的健康產生許多不利的影響。初始癥狀不典型，多表現為流鼻涕等上呼吸道卡他癥狀，亦為醫護的診斷和治療帶來極大挑戰。目前關于維生素A的研究主要集中在免疫、感染等方面，國內外關于專門的維生素A與百日咳感染的關系的研究較少，本研究通過對250例痙攣性咳嗽的患兒維生素A水平和百日咳感染的關系的比較，旨在闡明維生素A水平和百日咳感染的關系，為臨床診療提供指導。