| Objective:By studying serum levels of vitamin A,D,and E in children with recurrent respiratory tract infections(RRTIs)and related influencing factors,the relationship between vitamin A,D,and E and RRTIs in recurrent respiratory tract infections(RRTIs)is clarified,so as to provide reference and theoretical basis for the prevention and treatment of RTIs in children.Methods:A total of 278 children with respiratory tract infection hospitalized in Chengde Central Hospital from November 2018 to November 2019 were selected as the research subjects.The levels of vitamin A,D and E in the enrolled children were determined by high performance liquid chromatography and liquid phase tandem mass spectrometry.Among them,138 children with RRTIs were selected as the observation group(RRTIs group),and 140 children without reaching the diagnostic criteria of RRTIs were selected as the control group(non-RRTIs group).The general information,vitamin A,vitamin D,vitamin E levels,and the detection rates of normal,deficiency and deficiency of vitamin A,vitamin D,and vitamin E of the two groups were respectively compared.According to different age children in each group is divided into: the group of young children,preschool and school-age group,according to the different parts can be divided into: infection of the upper respiratory tract infections and lower respiratory tract infection group,respectively on two groups of children of different age groups and different infection group to compare the serum levels of vitamin A,D,E,and analyze the related factors affecting RRTIs happen.Results:1.There was no significant difference in general data between RRTIs group and non-RRTIs group(P > 0.05).2.Serum vitamin A(VA)levels in RRTIs group and non-RRTIs group were0.18±0.08mg/L and 0.21±0.07 mg/L,respectively,and RRTIs group was significantly lower than non-RRTIs group(P < 0.05).Serum 25-hydroxyvitamin D[25-hydroxy vitamin D,25-(OH)D] levels in RRTIs group and non-RRTIs group were 21.13±8.56ng/m L and 23.31±8.10ng/m L,respectively,which were significantly lower in RRTIs group than in non-RRTIs group(P < 0.05).Serum vitamin E(VE)levels in RRTIs group and non-RRTIs group were6.02±1.65mg/L and 6.24±1.72mg/L,respectively,with no statistical significance(P > 0.05).3.The detection rate of VA deficiency in RRTIs group and non-RRTIs group was 66.7% and 47.9%,respectively,and RRTIs group was significantly higher than non-RRTIs group(P < 0.05).The under-detection rate of VA in RRTIs group and non-RRTIs group was 24.6% and 42.1%,respectively,which was significantly lower in RRTIs group than in non-RRTIs group(P < 0.05).The normal detection rates of VA in RRTIs group and non-RRTIs group were 8.7%and 10.0%,respectively,and there was no significant difference between the two groups(P > 0.05).The detection rate of 25-(OH)D deficiency in RRTIs group and non-RRTIs group was 30.4% and 17.1%,respectively,which was significantly higher in RRTIs group than that in non-RRTIs group(P < 0.05).The under-detection rate of 25-(OH)D in RRTIs group and non-RRTIs group were 23.2% and 20.0%,respectively,and there was no significant difference between them(P >0.05).The normal detection rates of 25-(OH)D in RRTIs group and non-RRTIs group were 46.4% and 62.9%,respectively,which were significantly lower in RRTIs group than in non-RRTIs group(P < 0.05).There were no significant differences in VE deficiency,under-detection and normal detection rates between the RRTIs group and the non-RRTIs group(P > 0.05).4.The serum VA levels of children with RRTIs in young-children group,preschool group and school-age group were respectively 0.18±0.06 mg/L,0.18±0.08 mg/L and 0.20±0.08mg/L,respectively,and there was no statistical significance(P > 0.05).Serum 25-(OH)D levels were 26.73±9.00 ng/m L,20.35±7.79 ng/m L,16.89±6.91 ng/m L,Serum VE levels were 6.88±2.11mg/L,5.83±1.48 mg/L,5.56±1.11 mg/L,respectively.There were no significant differences in serum 25-(OH)D and VE levels between preschool group and school age group(P > 0.05).The serum 25-(OH)D and VE levels in youngchildren group were higher than those in preschool group and school age group,with statistical significance(P < 0.05).The serum VA levels of non-RRTIs children in young-children group,preschool group and school-age group were respectively 0.21±0.07mg/L,0.21±0.07mg/L and 0.21± 0.08 mg /L,respectively,and there was no statistical significance(P > 0.05).Serum 25-(OH)D levels were 30.41± 6.88 ng /m L,21.83± 7.48 ng /m L,18.89± 5.62 ng /m L,and serum VE levels were 7.15±1.59 mg /L,6.25± 1.78 mg /L,and 5.06± 0.83 mg /L,respectively.Serum 25-(OH)D and VE levels in the young-children group were higher than those in the preschool group and the school-age group,with statistical significance(P <0.05).There was significant difference in serum VE level between preschool group and school age group(P < 0.05),but no significant difference in serum25-(OH)D level(P > 0.05).5.The levels of VA,25-(OH)D and VE in RRTIs upper respiratory tract infection group were 0.18±0.10mg/L,19.68±7.67ng/m L and 6.30±1.79mg/L,respectively,while those in the lower respiratory tract infection group were0.18±0.07mg/L,21.48±8.76ng/m L and 5.95±1.61mg/L,respectively.There was no statistical significance in the levels of VA,25-(OH)D and VE between the two groups(P > 0.05).The levels of VA,25-(OH)D and VE in non-RRTIs upper respiratory tract infection group were 0.21±0.074mg/L,21.51±6.97ng/m L and 6.21±1.56mg/L,respectively,while those in lower respiratory tract infection group were0.21±0.07mg/L,23.80±8.35ng/m L and 6.25±1.77mg/L,respectively.There was no statistical significance in the levels of VA,25-(OH)D and VE between the two groups(P > 0.05).6.Analysis of related factors showed that breastfeeding(OR = 0.489,95%CL = 0.290-0.825),VA deficiency(OR = 2.366,95%CL = 1.430-3.915),25-(OH)D deficiency(OR = 2.402,95%CL = 1.330-4.337)were independent influencing factors for the occurrence of RRTIs in children.Breastfeeding was a protective factor for RRTIs,while VA deficiency and 25-(OH)D deficiency were risk factors for RRTIs.Conclusion:1.Serum vitamin A and D levels were associated with the occurrence of RRTIs in children,while serum VE level was not significantly associated with the occurrence of RRTIs in children.2.In both RRTI and non-RRTIs children,serum vitamin D and E levels were the highest in the infant group,while serum VA levels showed no significant difference in different age stages.3.There was no significant difference in serum vitamin A,D and E levels among children with different infection sites.4.Serum vitamin A and D deficiency can increase the risk of RRTIs in children. |
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