迟发性佝偻病与支气管哮喘

Late richets and bronchial asthma

目的 观察迟发性佝偻病并发哮喘的治疗反应 ,探讨维生素D(VD)缺乏在哮喘发病中的作用。方法 31例迟发性佝偻病并发哮喘患儿随机分成A、B两组 ,15例单纯哮喘患儿为C组。 3组均吸入二丙酸倍氯米松气雾剂 (becotideinhaler) 1年 ,A组另加VD3 治疗。于治疗前后分别测定肺功能等。结果 治疗前 3组用力呼气一秒量 (FEV1 0 )及用力呼气峰流速(PEF)均减低 ,但组间无差别 ;A、B两组骨钙素和反映气道敏感性的Dmin值较C组低 ,且A、B两组骨钙素与Dmin值呈正相关。治疗后 3组FEV1 0 和PEF比治疗前均有提高 ,A组提高最明显 ;气道敏感性较治疗前降低 ,其中A组最显著。B组骨钙素明显下降。结论 VD缺乏易致佝偻病患儿气道敏感性增加 ,骨钙素水平降低。对迟发性佝偻病并发哮喘在吸入皮质激素的同时加适量VD治疗可提高疗效 ,减少副作用。

Objective To observe the response to treatment in asthmatic children with late richets, and study the role of vitamin D(VD) deficiency in asthma. Methods Thirty-one asthmatics with richets were divided into group A and B at random, and other 15 asthmatics without richets regarded as group C.All inhaled beclomethasone dipropionate and group A got an injection for VD 3. At pre-and post-treatments, lung function were determined. Results Before treatment,the subjects showed an average fall in FEV 1 0 and peak expiratory flow (PEF).But no difference was found among the 3 groups. Compared with group C,groups A and B showed decrease in plasma OC level and D min , and OC level was correlated with D min ( r=0 678,P<0 05 ).One year treatment resulted in an improvement of lung function (FEV 1 0 and PEF) and decrease of airway sensitivity among the 3 groups, especially group A. Contrast with group A, groups B and C showed decrease in plasma OC. The decrease of group B showed significent difference with pre-treatment ( P<0 01).Conclusion Late richets is subjected to airway hypersensitivity and low OC level by VD deficiency. The treatment with inhaled corticosteroids and VD can reduce asthma attack episodes and side effects. [WT5”HZ]