维生素A与维生素D辅助治疗儿童肺炎的研究进展
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摘要
肺炎是儿童常见的感染性疾病,其主要病原为病毒、细菌、衣原体和支原体,严重影响儿童的健康。临床以抗生素治疗为主,但近年广谱抗生素的应用出现多种耐药菌株,导致治疗效果欠佳。随着临床及基础医学研究的深入,维生素A(Vit A)和维生素D(Vit D)在提高机体免疫方面起着较为重要的作用。因此,本文就Vit A和Vit D在辅助治疗儿童肺炎中所起到的作用及相关研究进展作一综述。
Pneumonia is a common infectious disease in children.Its main pathogens are viruses,bacteria,chlamydia and mycoplasma,which seriously affect children′s health.Antibiotics are mainly used in clinical treatment,but a variety of drug-resistant strains have appeared in the application of broad-spectrum antibiotics in recent years,resulting in poor treatment efficacy.With the deepening of clinical and basic medical research,vitamin A(Vit A)and vitamin D(Vit D)play an important role in improving the body′s immunity.Therefore,this paper reviews the roles of Vit A and Vit D in the adjuvant treatment of children′s pneumonia and related research progress.
Pneumonia is a common infectious disease in children.Its main pathogens are viruses,bacteria,chlamydia and mycoplasma,which seriously affect children′s health.Antibiotics are mainly used in clinical treatment,but a variety of drug-resistant strains have appeared in the application of broad-spectrum antibiotics in recent years,resulting in poor treatment efficacy.With the deepening of clinical and basic medical research,vitamin A(Vit A)and vitamin D(Vit D)play an important role in improving the body′s immunity.Therefore,this paper reviews the roles of Vit A and Vit D in the adjuvant treatment of children′s pneumonia and related research progress.
引文
[1] Rudan I,O′Brien KL,Nair H,et al.Epidemiology and etiology of childhood pneumonia in 2010:estimates of incidence,severe morbidity,mortality,underlying risk factors and causative pathogens for 192 countries[J].J Glob Health,2013,3(1):010401.
[2]李丽梅,李伟英.5岁以下儿童维生素A亚临床缺乏与贫血和呼吸道感染的关系及预防措施[J].临床和实验医学杂志,2014,13(22):1889-1891.
[3] Inamo Y,Hasegawa M,Saito K,et al.Serum vitamin D concentrations and associated severity of acute lower respiratory tract infections in Japanese hospitalized children[J].Pediatr Int,2011,53(2):199-201.
[4] Bowden SA,Robinson RF,Carr R,et al.Prevalence of vitamin D deficiency and insufficiency in children withosteopenia or osteoporosis referred to a pediatric metabolic bone clinic[J].Pediatrics,2008,121(6):1585-90.
[5]张宇,刘小兵,杨丽琛,等.2010—2012年中国6~17岁城市儿童维生素A营养状况[J].中华预防医学杂志,2017,51(2):117-120.
[6]丁媛慧,孙中厚,张海美,等.儿童边缘型维生素A缺乏与呼吸道感染相关性及危险因素分析[J].中国儿童保健杂志,2016,24(4):393-395.
[7]王军陵,叶静萍.维生素A在小儿肺炎治疗中的作用机制和疗效[J].临床合理用药杂志,2018,11(3):172-173.
[8] Xiang XS,Zhao YZ,Li N,et al.Accumulation of DC in laminapropria induced by FMS-like tyrosine kinase 3ligand aggravates the intestinal inflammatory response during endotoxemia[J].Inflammation,2010,33(1):34-45.
[9] Sirisinha S.The pleiotropic role of vitamin A in regulating mucosal immunity.[J].Asian Pac J Allergy Immunol,2015,33(2):71-89.
[10]吴立成.小剂量维生素A佐治新生儿感染性肺炎疗效观察[J].中国社区医师,2014,9(34):55.
[11]李莉,薛继红,任华.肺炎患儿治疗前后血清维生素A营养状况及铁含量的变化[J].中国儿童保健杂志,2015,23(10):1111-1113.
[12] Amaral CT,Ms NNP,Maciel BLL,et al.Vitamin A deficiency alters airway resistance in children with acute upper respiratory infection[J].Pediatric Pulmonology,2013,48(5):481-489.
[13] Kartasurya MI,Ahmed F,Subagio HW,et al.Zinc combined with vitamin A reduces upper respiratory tract infection morbidity in a randomised trial in preschool children in Indonesia[J].Br J Nutr,2012,108(12):2251-2260.
[14] Humphrey JH,Ichord RN.Safety of vitamin A supplementation of postpartum women and young children[J].Food&Nutrition Bulletin,2011,22(22):311-319.
[15]Hathcock JN.Vitamin and mineral safety[M].2nd ed.Washington DC:Council for Responsible Nutrition Press.2004:85-91.
[16] Binkley N,Ramamurthy R,Krueger D.Low vitamin D status:definition,prevalence,consequences,and correction[J].Endocrinol Metab Clin Nortb Am,2010,38(1):287-301.
[17] Zhao Y,Yu B,Mao X,et al.Dietary vitamin D supplementation attenuates immune responses of pigs challenged with rotavirus potentially through the retinoic acid-inducible gene I signalling pathway[J].Br J Nutr,2014,112(3):381.
[18]喻文,罗红敏.维生素D3对脓毒症患者维生素D和抗菌肽水平的影响:一项随机安慰剂对照试验[J].中华危重病急救医学,2016,28(2):98.
[19]李欣,岳冬辉,毕岩.呼吸道黏膜固有免疫抗流感病毒研究[J].中医药临床杂志,2017,29(6):759-761.
[20] Liu K,Nussenzweig MC.Origin and development of dendritic cells[J].Immunol Rev,2010,234(1):45-54.
[21] Jin CJ,Hong CY,Takei M,et al.All-trans retinoic acid inhibits the differentiation,maturation,and function of human monocyte-derived dendritic cells[J].Leukemia Research,2010,34(4):513.
[22]中华医学会儿科学分会呼吸学组.儿童社区获得性肺炎管理指南(2013修订)(上)[J].中华儿科杂志,2013,51(10):745-752.
[23]李敏,彭雁忠,熊晓佳.维生素D与免疫[J].国际免疫学杂志,2014,37(5):403-407.
[24] Chen S,Sims GP,Chen XX,et al.Modulatory effects of 1,25-Dihydroxyvitamin D3on human B cell differentiation[J].J Immunol,2007,179(3):1634-1647.
[25]丁玲,李温慈,张宇.维生素D辅治婴幼儿肺炎疗效观察[J].浙江中西医结合杂志,2016,26(12):1107-1109.
[26] Leis KS,Mcnally JD,Montgomery MR.急性下呼吸道感染儿童的维生素D摄入[J].中国当代儿科杂志,2012,14(1):1-6.
[27]钱婧,袁艺.血清25-(OH)D3水平与儿童社区获得性肺炎严重程度及免疫功能相关性研究[J].中国儿童保健杂志,2018,26(8):827-830.
[28]朱庆龄,盛晓阳.维生素D过量及中毒的研究进展[J].中华儿科杂志,2015,53(3):235-237.
[29] Casey CF,Slawson DC.Vitamin D supplementation in infants,children,and adolescents[J].Am Fam Physician,2010,81(81):745-748.
[2]李丽梅,李伟英.5岁以下儿童维生素A亚临床缺乏与贫血和呼吸道感染的关系及预防措施[J].临床和实验医学杂志,2014,13(22):1889-1891.
[3] Inamo Y,Hasegawa M,Saito K,et al.Serum vitamin D concentrations and associated severity of acute lower respiratory tract infections in Japanese hospitalized children[J].Pediatr Int,2011,53(2):199-201.
[4] Bowden SA,Robinson RF,Carr R,et al.Prevalence of vitamin D deficiency and insufficiency in children withosteopenia or osteoporosis referred to a pediatric metabolic bone clinic[J].Pediatrics,2008,121(6):1585-90.
[5]张宇,刘小兵,杨丽琛,等.2010—2012年中国6~17岁城市儿童维生素A营养状况[J].中华预防医学杂志,2017,51(2):117-120.
[6]丁媛慧,孙中厚,张海美,等.儿童边缘型维生素A缺乏与呼吸道感染相关性及危险因素分析[J].中国儿童保健杂志,2016,24(4):393-395.
[7]王军陵,叶静萍.维生素A在小儿肺炎治疗中的作用机制和疗效[J].临床合理用药杂志,2018,11(3):172-173.
[8] Xiang XS,Zhao YZ,Li N,et al.Accumulation of DC in laminapropria induced by FMS-like tyrosine kinase 3ligand aggravates the intestinal inflammatory response during endotoxemia[J].Inflammation,2010,33(1):34-45.
[9] Sirisinha S.The pleiotropic role of vitamin A in regulating mucosal immunity.[J].Asian Pac J Allergy Immunol,2015,33(2):71-89.
[10]吴立成.小剂量维生素A佐治新生儿感染性肺炎疗效观察[J].中国社区医师,2014,9(34):55.
[11]李莉,薛继红,任华.肺炎患儿治疗前后血清维生素A营养状况及铁含量的变化[J].中国儿童保健杂志,2015,23(10):1111-1113.
[12] Amaral CT,Ms NNP,Maciel BLL,et al.Vitamin A deficiency alters airway resistance in children with acute upper respiratory infection[J].Pediatric Pulmonology,2013,48(5):481-489.
[13] Kartasurya MI,Ahmed F,Subagio HW,et al.Zinc combined with vitamin A reduces upper respiratory tract infection morbidity in a randomised trial in preschool children in Indonesia[J].Br J Nutr,2012,108(12):2251-2260.
[14] Humphrey JH,Ichord RN.Safety of vitamin A supplementation of postpartum women and young children[J].Food&Nutrition Bulletin,2011,22(22):311-319.
[15]Hathcock JN.Vitamin and mineral safety[M].2nd ed.Washington DC:Council for Responsible Nutrition Press.2004:85-91.
[16] Binkley N,Ramamurthy R,Krueger D.Low vitamin D status:definition,prevalence,consequences,and correction[J].Endocrinol Metab Clin Nortb Am,2010,38(1):287-301.
[17] Zhao Y,Yu B,Mao X,et al.Dietary vitamin D supplementation attenuates immune responses of pigs challenged with rotavirus potentially through the retinoic acid-inducible gene I signalling pathway[J].Br J Nutr,2014,112(3):381.
[18]喻文,罗红敏.维生素D3对脓毒症患者维生素D和抗菌肽水平的影响:一项随机安慰剂对照试验[J].中华危重病急救医学,2016,28(2):98.
[19]李欣,岳冬辉,毕岩.呼吸道黏膜固有免疫抗流感病毒研究[J].中医药临床杂志,2017,29(6):759-761.
[20] Liu K,Nussenzweig MC.Origin and development of dendritic cells[J].Immunol Rev,2010,234(1):45-54.
[21] Jin CJ,Hong CY,Takei M,et al.All-trans retinoic acid inhibits the differentiation,maturation,and function of human monocyte-derived dendritic cells[J].Leukemia Research,2010,34(4):513.
[22]中华医学会儿科学分会呼吸学组.儿童社区获得性肺炎管理指南(2013修订)(上)[J].中华儿科杂志,2013,51(10):745-752.
[23]李敏,彭雁忠,熊晓佳.维生素D与免疫[J].国际免疫学杂志,2014,37(5):403-407.
[24] Chen S,Sims GP,Chen XX,et al.Modulatory effects of 1,25-Dihydroxyvitamin D3on human B cell differentiation[J].J Immunol,2007,179(3):1634-1647.
[25]丁玲,李温慈,张宇.维生素D辅治婴幼儿肺炎疗效观察[J].浙江中西医结合杂志,2016,26(12):1107-1109.
[26] Leis KS,Mcnally JD,Montgomery MR.急性下呼吸道感染儿童的维生素D摄入[J].中国当代儿科杂志,2012,14(1):1-6.
[27]钱婧,袁艺.血清25-(OH)D3水平与儿童社区获得性肺炎严重程度及免疫功能相关性研究[J].中国儿童保健杂志,2018,26(8):827-830.
[28]朱庆龄,盛晓阳.维生素D过量及中毒的研究进展[J].中华儿科杂志,2015,53(3):235-237.
[29] Casey CF,Slawson DC.Vitamin D supplementation in infants,children,and adolescents[J].Am Fam Physician,2010,81(81):745-748.