本文選題：維生素D + 兒童�。� 參考：《鄭州大學(xué)》2017年碩士論文

【摘要】：維生素D是一組具有生物活性的脂溶性類(lèi)固醇衍生物,長(zhǎng)期以來(lái),維生素D作為骨和礦物質(zhì)代謝的重要參與者被廣泛認(rèn)知,維生素D缺乏會(huì)導(dǎo)致兒童生長(zhǎng)遲緩和骨骼畸形,在成人中可引起骨軟化和骨質(zhì)疏松。近年來(lái)研究發(fā)現(xiàn),維生素D缺乏可能與自身免疫性疾病、癌癥、心血管疾病、代謝性疾病及呼吸道感染等疾病的發(fā)生風(fēng)險(xiǎn)增加有關(guān),因此,維生素D營(yíng)養(yǎng)狀況逐漸引起了人們的關(guān)注。兒童是維生素D缺乏的主要發(fā)病人群,并且處于生長(zhǎng)發(fā)育的關(guān)鍵時(shí)期,關(guān)于兒童維生素D不足與缺乏發(fā)生率的流行病學(xué)資料國(guó)內(nèi)外均較少,維生素D水平可因地域不同存在差異。對(duì)維生素D缺乏、不足以及維生素D最佳水平的界定非常重要,是否補(bǔ)充維生素D及確定治療應(yīng)達(dá)到的目標(biāo)取決于這些閾值,但目前對(duì)維生素D缺乏的界定尚未達(dá)成共識(shí)。呼吸道感染是嬰幼兒多發(fā)病,也是兒科最常見(jiàn)的疾病,這與小兒呼吸系統(tǒng)解剖特點(diǎn)和免疫系統(tǒng)發(fā)育不完善有關(guān)。有研究顯示,補(bǔ)充維生素D有利于減少呼吸道感染發(fā)病率,但此觀點(diǎn)目前存在爭(zhēng)議,維生素D是否與呼吸道感染相關(guān)尚需進(jìn)一步研究。目的1.以河南省1~7歲健康兒童為研究對(duì)象,采用化學(xué)發(fā)光法檢測(cè)血清25(OH)D水平,根據(jù)WS/T402-2012《臨床實(shí)驗(yàn)室檢驗(yàn)項(xiàng)目參考區(qū)間的制定》標(biāo)準(zhǔn),初步建立河南省1~7歲健康兒童血清25(OH)D參考區(qū)間,并與國(guó)家推薦使用的參考標(biāo)準(zhǔn)對(duì)比,了解河南省1~7歲健康兒童維生素D營(yíng)養(yǎng)狀況,為當(dāng)?shù)胤乐蝺和S生素D缺乏、合理補(bǔ)充維生素D提供科學(xué)依據(jù)。2.檢測(cè)1~3歲呼吸道感染患兒血清25(OH)D水平,分析維生素D營(yíng)養(yǎng)狀況與呼吸道感染的關(guān)系。方法1.根據(jù)地理位置及經(jīng)濟(jì)發(fā)展水平,采用分層整群隨機(jī)抽樣的方法,從河南省六個(gè)地市選取392名1~7歲健康兒童,首先按年齡分為幼兒組(1~3歲)和學(xué)齡前組(3~7歲),然后再細(xì)分為6組,分別為:1~2歲,2~3歲,3~4歲,4~5歲,5~6歲,6~7歲,化學(xué)發(fā)光法檢測(cè)血清25(OH)D水平,以WS/T402-2012《臨床實(shí)驗(yàn)室檢驗(yàn)項(xiàng)目參考區(qū)間的制定》為依據(jù),建立河南省1~7歲健康兒童血清25(OH)D水平參考區(qū)間。2.選取1~3歲呼吸道感染患兒108例,以30名同時(shí)期1~3歲健康幼兒作為對(duì)照,采用化學(xué)發(fā)光免疫分析儀檢測(cè)血清25(OH)D,與自建參考值范圍和國(guó)家推薦使用的參考標(biāo)準(zhǔn)[血清25(OH)D低于37.5nmol/L為缺乏,37.5nmol/L~50.0nmol/L為不足]比較。結(jié)果1.河南省1~7歲健康兒童血清25(OH)D水平1.1維生素D水平總體情況:392名河南省健康兒童血清25(OH)D最大值為134.2nmol/L,最小值為27.8nmol/L,中位數(shù)與四分位間距為42.1(37.0-53.3)nmol/L。1.2幼兒組與學(xué)齡前組維生素D水平比較:幼兒組與學(xué)齡前組血清25(OH)D水平及其不足與缺乏發(fā)生率有顯著差異(Z=5.631,P0.001;χ2=11.045,P0.001)。1.3河南省健康幼兒與學(xué)齡前兒童血清25(OH)D參考區(qū)間:河南省健康幼兒血清25(OH)D水平95%參考值范圍為(30.5-107.8)nmol/L,學(xué)齡前兒童血清25(OH)D水平95%參考值范圍為(29.8-91.5)nmol/L,下限值與上限值均低于我國(guó)現(xiàn)行推薦的標(biāo)準(zhǔn)(50.0-250.0)nmol/L。2.呼吸道感染患兒血清25(OH)D水平2.1維生素D水平總體情況:108名呼吸道感染患兒血清25(OH)D水平最大值為133.8nmol/L,最小值為28.0nmol/L,平均水平為(38.9±23.8)nmol/L。2.2呼吸道感染患兒與健康幼兒維生素D水平比較:呼吸道感染患兒與同期對(duì)照組幼兒及河南省健康幼兒相比,血清25(OH)D水平較低,維生素D不足與缺乏發(fā)生率較高(H=8.473,P=0.015;χ2=21.874,P0.001)。結(jié)論1.通過(guò)對(duì)河南省六地市1~7歲健康兒童維生素D水平分析,初步建立了河南省1~7歲健康兒童血清25(OH)D參考區(qū)間,其上限值與下限值均低于國(guó)家推薦標(biāo)準(zhǔn)。2.呼吸道感染患兒維生素D水平較低,呼吸道感染可能與維生素D缺乏有關(guān)。
[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.
【學(xué)位授予單位】：鄭州大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類(lèi)號(hào)】：R723.2

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本文編號(hào)：1961940