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维生素 D 状况与尼泊尔重症肺炎儿童的治疗失败和疾病持续时间有关。

Vitamin D status is associated with treatment failure and duration of illness in Nepalese children with severe pneumonia.

机构信息

Department of Microbiology, Innlandet Hospital Trust, Lillehammer, Norway.

Department of Child Health, Institute of Medicine, Tribhuvan University, Kathmandu, Nepal.

出版信息

Pediatr Res. 2017 Dec;82(6):986-993. doi: 10.1038/pr.2017.71. Epub 2017 Aug 16.

Abstract

BackgroundThere is no consensus on optimal Vitamin D status. The objective of this study was to estimate the extent to which vitamin D status predicts illness duration and treatment failure in children with severe pneumonia by using different cutoffs for vitamin D concentration.MethodsWe measured the plasma concentration of 25(OH)D in 568 children hospitalized with World Health Organization-defined severe pneumonia. The associations between vitamin D status, using the most frequently used cutoffs for vitamin D insufficiency (25(OH)D<50 and <75 nmol/l), and risk for treatment failure and time until recovery were analyzed in multiple logistic regression and Cox proportional hazards models, respectively.ResultsOf the 568 children, 322 (56.7%) had plasma 25(OH)D levels ≥75 nmol/l, 179 (31.5%) had levels of 50-74.9 nmol/l, and 67 (%) had levels <50 nmol/l. Plasma 25(OH)D <50 nmol/l was associated with increased risk for treatment failure and longer time until recovery.ConclusionOur findings indicate that low vitamin D status (25(OH)D<50 nmol/l) is an independent risk factor for treatment failure and delayed recovery from severe lower respiratory infections in children.

摘要

背景

目前对于维生素 D 的最佳状态仍没有共识。本研究的目的是使用不同的维生素 D 浓度切点,评估维生素 D 状态对严重肺炎患儿疾病持续时间和治疗失败的预测程度。

方法

我们测量了 568 名患有世界卫生组织定义的严重肺炎住院儿童的血浆 25(OH)D 浓度。使用最常使用的维生素 D 不足切点(25(OH)D<50 和 <75 nmol/l)来评估维生素 D 状态与治疗失败风险和恢复时间之间的关系,分别采用多元逻辑回归和 Cox 比例风险模型进行分析。

结果

在 568 名儿童中,322 名(56.7%)的血浆 25(OH)D 水平≥75 nmol/l,179 名(31.5%)的水平为 50-74.9 nmol/l,67 名(11.8%)的水平<50 nmol/l。血浆 25(OH)D<50 nmol/l与治疗失败风险增加和严重下呼吸道感染恢复时间延长相关。

结论

我们的研究结果表明,低维生素 D 状态(25(OH)D<50 nmol/l)是儿童严重下呼吸道感染治疗失败和恢复延迟的独立危险因素。

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