血清25-（OH）D及体外过敏原检测在婴幼儿反复呼吸道感染中的临床意义分析

Clinical significance of serum 25-hydroxyvitamin D and in vitro allergen testing in infants with recurrent respiratory tract infections

摘要:

目的 探讨血清25-羟维生素D［25-（OH）D］水平及体外过敏原检测在婴幼儿反复呼吸道感染中的临床意义。方法 选取2022年1月—2025年1月扬州大学医学院附属扬州妇幼保健院收治的94例反复呼吸道感染患儿为观察组，另选取50例急性呼吸道感染患儿为急性感染组，50例健康婴幼儿为对照组。检测各组血清25-（OH）D水平及常见过敏原阳性率，采用多因素一般Logistic回归分析反复呼吸道感染发生的危险因素，并通过ROC曲线评估25-（OH）D联合过敏原检测对反复呼吸道感染的预测价值。结果 观察组患儿血清25-（OH）D水平低于急性感染组和对照组（P <0.05），血清IgE水平高于急性感染组和对照组（P <0.05）；急性感染组患儿血清25-（OH）D水平低于对照组（P <0.05），血清IgE水平高于对照组（P <0.05）。观察组患儿的尘螨、猫/狗毛皮屑、混合霉菌、鸡蛋、牛奶的阳性率高于急性感染组和对照组（P <0.05）。尘螨过敏［O^R =7.718（95% CI：1.763，33.787）］、猫狗毛皮屑过敏［O^R =26.220（95% CI：3.525，195.054）］、混合霉菌过敏［O^R =32.663（95% CI：4.549，234.518）］、鸡蛋过敏［O^R =40.089（95% CI：4.962，323.913）］和牛奶过敏［O^R =27.052（95% CI：3.307，221.303）］均为发生反复呼吸道感染的危险因素（P <0.05），25-（OH）D水平低［O^R =0.952（95% CI：0.936，0.969）］是发生反复呼吸道感染的保护因素（P <0.05）。血清25-（OH）D及体外过敏原检测联合预测婴幼儿发生反复呼吸道感染的曲线下面积为0.978（95% CI：0.953，1.000），敏感性为94.7%（95% CI：0.880，0.983），特异性为96.0%（95% CI：0.863，0.995）。结论 血清25-（OH）D缺乏和过敏原致敏状态与婴幼儿反复呼吸道感染的发生发展密切相关，联合检测对反复呼吸道感染的早期识别和干预具有重要临床价值。

Abstract:

Objective To investigate the clinical significance of serum 25-hydroxyvitamin D [25-(OH)D] levels and allergen-specific IgE testing in infants with recurrent respiratory tract infection (RRTI).Methods A total of 94 infants with RRTI (observation group), 50 with acute respiratory infection (acute group), and 50 healthy infants (control group) were enrolled from January 2022 to January 2025. Serum 25-(OH)D levels and allergen-specific IgE positivity rates were measured. Multivariate logistic regression identified risk factors for RRTI. ROC analysis evaluated the predictive value of combined 25-(OH)D and allergen testing.Results The serum 25-(OH)D levels in the observation group were lower than those in the acute infection group and the control group (P < 0.05), while the serum IgE levels were higher than those in the acute infection group and the control group (P < 0.05). The serum 25-(OH)D levels in the acute infection group were lower than those in the control group (P < 0.05), and the serum IgE levels were higher than those in the control group (P < 0.05). The positive rates for dust mites, cat/dog dander, mixed molds, eggs, and milk in the observation group were higher than those in the acute infection group and the control group (P < 0.05). Allergy to dust mites [O^R = 7.718 (95% CI: 1.763, 33.787)], allergy to cat/dog dander [O^R = 26.220 (95% CI: 3.525, 195.054)], allergy to mixed molds [O^R = 32.663 (95% CI: 4.549, 234.518)], allergy to eggs [O^R = 40.089 (95% CI: 4.962, 323.913)], and allergy to milk [O^R = 27.052 (95% CI: 3.307, 221.303)] were all risk factors for recurrent respiratory tract infections (P < 0.05), while low serum 25-(OH)D levels [O^R = 0.952 (95% CI: 0.936, 0.969)] were a protective factor against recurrent respiratory tract infections (P < 0.05). The combination of serum 25-(OH)D level and in vitro allergen testing for predicting recurrent respiratory tract infections in infants had an area under the curve of 0.978 (95% CI: 0.953, 1.000), with a sensitivity of 94.7% (95% CI: 0.880, 0.983) and a specificity of 96.0% (95% CI: 0.863, 0.995).Conclusion Vitamin D deficiency and allergen sensitization are closely associated with RRTI in infants. Combined assessment provides valuable clinical guidance for early identification and intervention.