维生素D与儿童急性炎症合并贫血的相关性研究

doi:10.20274/j.cnki.issn.1674-3865.2026.01.015

摘要/Abstract

摘要：

目的探讨维生素D在急性炎症合并贫血的患儿体内的表达水平及相关性，为临床防治儿童急性炎症合并贫血提供依据。方法前瞻性选取2023年10月至2025年3月石河子大学第一附属医院儿科就诊的1～14岁儿童作为研究对象，其中急性炎症合并贫血组100例、急性炎症不伴贫血组100例以及健康对照组100例。对3组儿童的临床资料及实验室指标进行检测比较，并运用多元线性回归分析，探究儿童急性炎症合并贫血发生的影响因素，并探究25-羟维生素D与儿童急性炎症合并贫血的关系。结果急性炎症合并贫血组、急性炎症不伴贫血组的25-羟维生素D及血红蛋白水平均低于健康对照组，差异均有统计学意义（P<0.05）。急性炎症合并贫血组与急性炎症不伴贫血组相比，C反应蛋白、白细胞计数、降钙素原、25-羟维生素D水平差异有统计学意义，将以上指标带入多元Logistic回归分析模型中，分析结果显示，白细胞计数水平的升高对于该疾病的危险不显著，低25-羟维生素D水平、高C反应蛋白、降钙素原水平是儿童急性炎症合并贫血发生的危险因素，三者的阈值分别为48.25 μg/L、27.76 ng/L、0.91 mg/L；其曲线下面积分别为0.850、0.705、0.754，联合应用的曲线下面积为0.913，这说明三者联合应用的诊断效能更高。结论低维生素D水平及高炎症介质水平是急性炎症合并贫血发生的危险因素，补充维生素D可能有助于降低急性炎症合并贫血的发生。

关键词: 急性炎症, 贫血, 维生素D, 儿童

Abstract:

Objective To explore the expression level and correlations of vitamin D in children with acute inflammation complicated by anemia, so as to provide a basis for the clinical prevention and treatment of this condition in children. Methods The children aged 1-14 years who were treated at the Department of Pediatrics of the First Affiliated Hospital of Shihezi University between October 2023 and March 2025 were prospectively recruited as the research subjects. Among them, there were 100 cases in the group of acute inflammation complicated by anemia, 100 cases in the group of acute inflammation without anemia, and 100 cases in the healthy control group. The clinical data and laboratory parameters of the three groups of children were measured and compared. Multivariate linear regression analysis was employed to explore the influencing factors for the occurrence of acute inflammation complicated by anemia in children and to investigate the association between 25-hydroxyvitamin D and acute inflammation complicated by anemia in children. Results The levels of 25(OH)D and Hb in the group of acute inflammation with anemia and the group of acute inflammation without anemia were lower than those in the healthy control group, and the differences were statistically significant(P<0.05). Comparing the group of acute inflammation with anemia with the group of acute inflammation without anemia, the differences in the levels of CRP, PCT, and 25(OH)D were statistically significant. When the above indicators were introduced into the multivariate Logistic regression analysis model, the analysis results showed that low 25(OH)D level, and high CRP and PCT levels were risk factors for the occurrence of acute inflammation with anemia in children, and the thresholds of the three were 48.25 μg/L, 27.76 ng/L, and 0.91 mg/L, respectively; their AUCs were 0.850, 0.705, and 0.754, respectively, and the area under the curve of the combined application was 0.913, which indicated that the diagnostic efficiency of the combined application of the three was higher. Conclusions Low vitamin D levels and high inflammatory mediator levels are risk factors for the incidence of acute inflammation complicated by anemia. Vitamin D supplementation may contribute to reducing the incidence of acute inflammation complicated by anemia.

Key words: Acute inflammation, Anemia, Vitamin D, Child

中图分类号:

R725.5

宋亚文, 陈波. 维生素D与儿童急性炎症合并贫血的相关性研究[J]. 中国中西医结合儿科学, 2026, 18(1): 77-81.

Yawen SONG, Bo CHEN. Research on the association between vitamin D and acute inflammation complicated by anemia in children[J]. Chinese Pediatrics of Integrated Traditional and Western Medicine, 2026, 18(1): 77-81.

图/表 5

表1

表2

急性炎症伴贫血组、急性炎症不伴贫血组炎症指标比较（ x ± s ）"

组别	n	C反应蛋白（mg/L）	白细胞介素-6（μg/L）	降钙素原（ng/L）	中性粒细胞计数（ $× 109$ /L）	白细胞计数（ $× 109$ /L）
急性炎症合并贫血	100	33.00±28.54	27.27±24.55	1.47±1.44	5.69±3.89	11.29±4.32
急性炎症不伴贫血	100	12.46±7.81	26.37±24.96	0.51±0.59	4.81±2.21	9.78±4.17
t值		6.942	0.258	6.154	1.960	2.496
P值		<0.001	0.797	<0.001	0.052	0.013

表2

表3

表4

图1

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组别	n	血红蛋白(g/L）	25-羟维生素D(μg/L)
健康对照组	100	112.79±3.90	66.07±9.29
急性炎症不伴贫血组	100	107.52±5.17^b	53.39±7.34^b
急性炎症合并贫血组	100	102.99±9.76^ab	38.37±12.97^ab
F值		52.65	187.09
P值		<0.001	<0.001

因素	β值	SE	Wald	P值	OR值	95%CI
常数	2.781	1.223	5.174	0.023	-	-
C反应蛋白	0.065	0.018	13.415	<0.001	1.068	1.031～1.106
降钙素原	1.440	0.414	12.113	0.001	4.219	1.876～9.492
25-羟维生素D	-0.120	0.024	26.214	<0.001	0.886	0.847～0.928
白细胞计数	0.088	0.047	3.440	0.064	1.092	0.995～1.198

指标	曲线下面积(95%CI)	阈值	灵敏度	特异度	约登指数
25-羟维生素D	0.850（0.794～0.906）	48.25 μg/L	0.83	0.73	0.56
降钙素原	0.754（0.684～0.823）	0.91 mg/L	0.53	0.96	0.49
C反应蛋白	0.705（0.629～0.782）	27.76 ng/L	0.52	0.97	0.49
联合应用	0.913（0.871～0.954）	0.49	0.79	0.92	0.71