广西医学

目的探讨呼吸道感染伴炎症指标升高患儿血清维生素A缺乏状况及其影响因素。方法选取129例呼吸道感染伴炎症指标升高患儿作为感染组，另选取同期66例健康体检儿童作为对照组，比较两组研究对象的血清维生素A水平、维生素A缺乏状况。收集感染组患儿的人口学特征、围生期情况、母乳喂养持续时间、饮食起居的规律、既往史、生活方式、血生化指标等一般资料，采用Spearman秩相关分析呼吸道感染伴炎症指标升高患儿的血清维生素A水平与白细胞计数（WBC）、C反应蛋白（CRP）、降钙素原（PCT）的相关性，采用多因素Logistic回归模型分析呼吸道感染伴炎症指标升高患儿维生素A缺乏的影响因素。结果感染组的血清维生素A水平低于对照组，且维生素A缺乏率（52.71%）高于对照组（4.55%）（P<0.05）。Spearman秩相关分析结果显示，感染组的血清维生素A水平与CRP、PCT呈负相关（P<0.05），与WBC无相关性（P>0.05）。多因素Logistic回归分析结果显示，白蛋白水平降低、前白蛋白水平降低、有反复呼吸道感染史是呼吸道感染伴炎症指标升高患儿维生素A缺乏的危险因素（P<0.05）。结论呼吸道感染伴炎症指标升高患儿存在血清维生素A缺乏的患儿比例较高，且受前白蛋白水平、白蛋白水平、反复呼吸道感染史的影响。临床上应早期识别并及时制订针对性干预策略，以改善患儿预后。

Objective To investigate the status of serum vitamin A deficiency and its influencing factors for children with respiratory tract infection and concomitant elevated inflammatory markers. Methods A total of 129 children with respiratory tract infection and concomitant elevated inflammatory markers were selected as the infection group, and 66 healthy check⁃up children during the same period were selected as the control group. Serum vitamin A levels and vitamin A deficiency status were compared between the research subjects of the two groups. General data including demographic characteristics, perinatal conditions, duration of breastfeeding, dietary and daily routine regularity, medical history, lifestyle, and blood biochemical indicators were collected from children in the infection group. Spearman's rank correlation analysis was used to identify the correlations between serum vitamin A levels and white blood cell count (WBC), C⁃reactive protein (CRP), and procalcitonin (PCT) in children with respiratory tract infection and concomitant elevated inflammatory markers. Multivariate Logistic regression model was adopted to identify the influencing factors for vitamin A deficiency in children with respiratory tract infection and concomitant elevated inflammatory markers. Results The serum vitamin A level in the infection group was lower than that in the control group, and the vitamin A deficiency rate (52.71%) was higher than that in the control group (4.55%) (P<0.05). Spearman's rank correlation analysis results revealed that serum vitamin A levels in the infection group negatively correlated with CRP and PCT (P<0.05), but were not correlated with WBC (P>0.05). Multivariate Logistic regression analysis results indicated that decreased albumin level, decreased prealbumin level, and the history of recurrent respiratory tract infections were risk factors for vitamin A deficiency in children with respiratory tract infection and concomitant elevated inflammatory markers (P<0.05). Conclusion The proportion of children with respiratory tract infection and concomitant elevated inflammatory markers who have serum vitamin A deficiency is relatively high, and it is affected by prealbumin and albumin levels, and the history of recurrent respiratory tract infections. In clinic, early recognition and timely targeted intervention strategies should be formulated to improve the prognosis of these children.