傅雯静 邓镜业

[关键词] 维生素A;百日咳;儿童;痉挛性咳嗽

[中图分类号] R179          [文献标识码] B          [文章编号] 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又明视黄醇，为脂溶性维生素，主要生理功能为维持正常的生长、生殖、视觉、上皮组织健全及抗感染免疫功能。维生素A对上皮组织的形成、发育和维持健全十分重要，影响上皮细胞黏膜中糖蛋白的合成，促其形成正常结构，缺乏时上皮组织结构受损，呼吸道、消化道、泌尿生殖道、消化道系统内膜上皮细胞受损容易发生感染[1]。维生素A缺乏（Vitamin A deficiency，VAD）是目前世界卫生组织确认的世界四大营养缺乏病之一，是21世纪末需要被重点解决的儿童健康问题[2]。百日咳为百日咳鲍特氏杆菌引起的急性呼吸道传染病。其特点为阵发性痉挛性咳嗽，且病程可长达数月[3]。由于疫苗的广泛接种，我国百日咳的流行已大大减少，发病率、病死率也明显降低。但是近年来，世界各地报道百日咳的发病情况有上升的趋势。特别在青少年人群，由于症状的不典型，实际感染人数可能比报道的要多[4]。由于百日咳感染的病程长，症状严重，对青少年儿童的健康产生许多不利的影响。初始症状不典型，多表现为流鼻涕等上呼吸道卡他症状，亦为医护的诊断和治疗带来极大挑战。目前关于维生素A的研究主要集中在免疫、感染等方面，国内外关于专门的维生素A与百日咳感染的关系的研究较少，本研究通过对250例痉挛性咳嗽的患儿维生素A水平和百日咳感染的关系的比较，旨在阐明维生素A水平和百日咳感染的关系，为临床诊疗提供指导。