河南省1～7岁健康儿童维生素D水平分析及其临床应用

发布时间：2018-06-01 00:04

本文选题：维生素D + 儿童　；参考：《郑州大学》2017年硕士论文

【摘要】：维生素D是一组具有生物活性的脂溶性类固醇衍生物,长期以来,维生素D作为骨和矿物质代谢的重要参与者被广泛认知,维生素D缺乏会导致儿童生长迟缓和骨骼畸形,在成人中可引起骨软化和骨质疏松。近年来研究发现,维生素D缺乏可能与自身免疫性疾病、癌症、心血管疾病、代谢性疾病及呼吸道感染等疾病的发生风险增加有关,因此,维生素D营养状况逐渐引起了人们的关注。儿童是维生素D缺乏的主要发病人群,并且处于生长发育的关键时期,关于儿童维生素D不足与缺乏发生率的流行病学资料国内外均较少,维生素D水平可因地域不同存在差异。对维生素D缺乏、不足以及维生素D最佳水平的界定非常重要,是否补充维生素D及确定治疗应达到的目标取决于这些阈值,但目前对维生素D缺乏的界定尚未达成共识。呼吸道感染是婴幼儿多发病,也是儿科最常见的疾病,这与小儿呼吸系统解剖特点和免疫系统发育不完善有关。有研究显示,补充维生素D有利于减少呼吸道感染发病率,但此观点目前存在争议,维生素D是否与呼吸道感染相关尚需进一步研究。目的1.以河南省1~7岁健康儿童为研究对象,采用化学发光法检测血清25(OH)D水平,根据WS/T402-2012《临床实验室检验项目参考区间的制定》标准,初步建立河南省1~7岁健康儿童血清25(OH)D参考区间,并与国家推荐使用的参考标准对比,了解河南省1~7岁健康儿童维生素D营养状况,为当地防治儿童维生素D缺乏、合理补充维生素D提供科学依据。2.检测1~3岁呼吸道感染患儿血清25(OH)D水平,分析维生素D营养状况与呼吸道感染的关系。方法1.根据地理位置及经济发展水平,采用分层整群随机抽样的方法,从河南省六个地市选取392名1~7岁健康儿童,首先按年龄分为幼儿组(1~3岁)和学龄前组(3~7岁),然后再细分为6组,分别为:1~2岁,2~3岁,3~4岁,4~5岁,5~6岁,6~7岁,化学发光法检测血清25(OH)D水平,以WS/T402-2012《临床实验室检验项目参考区间的制定》为依据,建立河南省1~7岁健康儿童血清25(OH)D水平参考区间。2.选取1~3岁呼吸道感染患儿108例,以30名同时期1~3岁健康幼儿作为对照,采用化学发光免疫分析仪检测血清25(OH)D,与自建参考值范围和国家推荐使用的参考标准[血清25(OH)D低于37.5nmol/L为缺乏,37.5nmol/L~50.0nmol/L为不足]比较。结果1.河南省1~7岁健康儿童血清25(OH)D水平1.1维生素D水平总体情况:392名河南省健康儿童血清25(OH)D最大值为134.2nmol/L,最小值为27.8nmol/L,中位数与四分位间距为42.1(37.0-53.3)nmol/L。1.2幼儿组与学龄前组维生素D水平比较:幼儿组与学龄前组血清25(OH)D水平及其不足与缺乏发生率有显著差异(Z=5.631,P0.001;χ2=11.045,P0.001)。1.3河南省健康幼儿与学龄前儿童血清25(OH)D参考区间:河南省健康幼儿血清25(OH)D水平95%参考值范围为(30.5-107.8)nmol/L,学龄前儿童血清25(OH)D水平95%参考值范围为(29.8-91.5)nmol/L,下限值与上限值均低于我国现行推荐的标准(50.0-250.0)nmol/L。2.呼吸道感染患儿血清25(OH)D水平2.1维生素D水平总体情况:108名呼吸道感染患儿血清25(OH)D水平最大值为133.8nmol/L,最小值为28.0nmol/L,平均水平为(38.9±23.8)nmol/L。2.2呼吸道感染患儿与健康幼儿维生素D水平比较:呼吸道感染患儿与同期对照组幼儿及河南省健康幼儿相比,血清25(OH)D水平较低,维生素D不足与缺乏发生率较高(H=8.473,P=0.015;χ2=21.874,P0.001)。结论1.通过对河南省六地市1~7岁健康儿童维生素D水平分析,初步建立了河南省1~7岁健康儿童血清25(OH)D参考区间,其上限值与下限值均低于国家推荐标准。2.呼吸道感染患儿维生素D水平较低,呼吸道感染可能与维生素D缺乏有关。
[Abstract]:Vitamin D is a group of bioactive fat soluble steroid derivatives. Vitamin D is widely recognized as an important participant in bone and mineral metabolism for a long time. Vitamin D deficiency can cause growth retardation and bone malformation in children. In adults, osteomalacia and osteoporosis can be caused. In recent years, vitamin D deficiency can be found. It is associated with increased risk of autoimmune diseases, cancer, cardiovascular disease, metabolic diseases and respiratory infections. Therefore, vitamin D nutritional status has gradually aroused people's attention. Children are the main pathogenesis of vitamin D deficiency, and are at a critical period of growth and development of children with vitamin D deficiency and The epidemiological data of lack of incidence are relatively small at home and abroad, vitamin D levels can vary from region to region. Vitamin D deficiency, deficiency, and the definition of vitamin D best level are very important. Whether vitamin D is supplemented and the goal of determining treatment depends on these thresholds, but the current definition of vitamin D deficiency has not yet been defined. There is a consensus. Respiratory infection is the most common disease in infants and children, and is also the most common disease in pediatrics. It is related to the dissection of the respiratory system and the development of immune system. Studies have shown that vitamin D supplementation is beneficial to reduce the incidence of respiratory infection, but this view is currently in dispute, whether vitamin D is associated with respiratory infection Further study is needed. 1. the level of serum 25 (OH) D was detected by chemiluminescence in healthy children aged 1~7 years in Henan province. According to the standard of establishing the reference interval of the clinical laboratory test of WS/T402-2012<, the reference interval of serum 25 (OH) D for healthy children of 1~7 years old in Henan province was preliminarily established, and the reference standard recommended by the state was also established. To compare the nutritional status of vitamin D in healthy children of 1~7 years old in Henan Province, to provide scientific basis for local prevention and control of vitamin D deficiency and reasonable supplement of vitamin D in children with 1~3 years of respiratory infection, the serum 25 (OH) D level was detected, and the relationship between vitamin D nutrition status and respiratory infection was analyzed. Method 1. according to geographical location and economic development Level, the method of stratified cluster random sampling was used to select 392 1~7 years old healthy children from six cities in Henan province. First, they were divided into 6 groups according to age group (1~3 years old) and preschool group (3~7 years old), and then subdivided into 6 groups, respectively: 1~2 years, 2~3 years, 3~4 years, 4~5 years, 5~ 6 years, 6~7 years, chemiluminescence detection of D levels of serum 25 (OH), with WS/T402-2012< impending Based on the formulation of the reference interval of the bed laboratory test project, the reference interval of serum 25 (OH) D of healthy children aged 1~7 years was established in 108 children with 1~3 years old respiratory infection, and 30 healthy infants of the same period 1~3 years old were used as control, and the serum 25 (OH) D was detected by chemiluminescence immunoanalyzer, and the range of reference value and the national reference value range and country were established. The recommended reference standard [serum 25 (OH) D is lower than 37.5nmol/L and 37.5nmol/L~50.0nmol/L is insufficient]. Results 1. the total level of serum 25 (OH) D level 1.1 vitamin D in 1~7 years old healthy children in Henan Province: the maximum value of 25 (OH) D of 392 healthy children in Henan province is 134.2nmol/L, the minimum value is 27.8nmol/L, median and four. Comparison of vitamin D levels between 42.1 (37.0-53.3) nmol/L.1.2 children and preschool age group: the level of serum 25 (OH) D and its deficiency in preschool group and preschool age group have significant difference (Z=5.631, P0.001; Chi 2=11.045, P0.001).1.3 in Henan healthy children and preschool children's serum 25 (OH) D reference interval: healthy infant serum in Henan Province 25 (OH) D level 95% reference value range is (30.5-107.8) nmol/L, preschool children's serum 25 (OH) D level 95% reference range is (29.8-91.5) nmol/L, lower and upper limit values are lower than our current recommended standard (50.0-250.0) nmol/L.2. respiratory infection children's serum 25 (OH) D level 2.1 vitamin levels overall: 108 respiratory tract infection The maximum level of serum 25 (OH) D in children was 133.8nmol/L, the minimum value was 28.0nmol/L, the average level was (38.9 + 23.8), and the level of vitamin D in children with nmol/L.2.2 respiratory infection and healthy children was compared with that of healthy children: the children with respiratory infection were compared with the children of the control group and the healthy children in Henan Province, the serum level of 25 (OH) D was lower, and the deficiency of vitamin D and the lack of hair were lacking. The rate of birth was higher (H=8.473, P=0.015; X 2=21.874, P0.001). Conclusion by analyzing the vitamin D level of healthy children of 1~7 years old in six cities of Henan Province, the serum 25 (OH) D reference interval of healthy children of 1~7 years old in Henan province was preliminarily established. The upper limit and lower limit were lower than the low vitamin D level of children with.2. respiratory tract infection, and the respiratory tract was lower. Infection may be associated with vitamin D deficiency.
【学位授予单位】：郑州大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R723.2

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