维生素D水平与儿童哮喘发病的相关性分析

Correlation Between Vitamin D Levels and Childhood Asthma

目的研究血清维生素D(Vitamin D,VitD)水平与儿童哮喘发病的相关性,期望为VitD在儿童哮喘的应用提供一定的理论依据。方法选择支气管哮喘患儿90例,随机分为VitD治疗组和常规治疗组,选择同期30例年龄和性别相匹配的健康儿童作为对照组;采用电化学发光免疫法测定血清中的25羟维生素D[25-hydroxyvitamin D,25(OH)D]浓度,酶联免疫吸附测定(enzyme linked immunosorbent assay,ELISA)方法检测血清免疫球蛋白E(immunoglobulin E,IgE)的水平,荧光酶联免疫法测定血清嗜酸性粒细胞阳离子蛋白(eosinophil cationic protein,ECP)、常规外周血嗜酸性粒细胞(eosinophils,EOS)计数,记录患儿住院天数,并随访1年内哮喘再次发作次数;并用Pearson相关分析探讨VitD水平与ECP、IgE水平及EOS计数的相关性。结果哮喘患儿血清25(OH)D的水平较对照组低,血清ECP、IgE水平及EOS计数较对照组高,两组比较差异有统计学意义(P<0.01);VitD治疗后患儿血清25(OH)D水平增高,血清ECP、IgE水平及EOS计数降低,治疗前后比较差异有统计学意义(P<0.01);常规治疗组血清ECP、IgE水平及EOS计数较治疗前显著下降,治疗前后比较差异有统计学意义(P<0.01),而血清25(OH)D水平无显著变化。相较于常规治疗组,VitD治疗组血清25(OH)D水平升高,血清ECP、IgE水平及EOS计数降低,患儿平均住院天数缩短,1年内哮喘发病次数较常规治疗组显著减少,组间比较差异有统计学意义(P均<0.01)。哮喘患儿血清VitD水平与ECP、IgE水平及EOS含量高度负相关(r分别为-0.456,-0.369,-0.513,P均<0.01)。结论 VitD缺乏与儿童哮喘的发病密切相关,补充适量VitD可显著改善哮喘患儿生活质量。

Objective To study the relationship between serum Vitamin D（VitD）levels and asthma in children,and provide a theoretical basis of VitD for children asthma.Methods Ninety children with bronchial asthma were randomly divided into VitD treatment group and routine treatment group.Meanwhile,30 healthy children matched for age and sex were selected as control group. Electrochemiluminescence immunoassay was used to determine serum25-hydroxyvitamin D [25（OH）D]concentrations,enzyme-linked immunosorbent assay（ELISA）was detected serum immunoglobulin E（IgE）levels,and serum eosinophil cationic protein（ECP）and routine peripheral blood eosinophils（EOS）counts were measured by fluorescence enzyme-linked immunosorbent assay.The hospital stays were recorded.The numbers of relapses of asthma were followed up within 1 year.Pearson correlation analysis was used to investigate the correlation between VitD levels and ECP,IgE levels and EOS counts.Results The serum25（OH）D levels in asthmatic children were lower than those in control group,but the serum ECP,IgE levels and EOS counts were higher than those in control group（P〈0.01）.After VitD treatment,the serum25（OH）D levels increased,but the ECP,IgE levels and EOS counts decreased（P0.01）.Serum ECP,IgE levels and EOS counts were significantly decreased in routine treatment groups（P〈0.01）,but serum25（OH）D levels had not changed（P〈0.05）.Compared with the routine treatment group,the serum25（OH）D levels increased in the VitD treatment group,but the serum ECP,IgE levels and EOS counts decreased,the average length of hospital stay in the VitD treatment group shortened,the number of asthma attacks in 1 year reduced（all P0.01）.The serum VitD levels were negatively correlated with ECP,IgE levels and EOS counts in children with asthma（r=-0.456,-0.369,-0.513,all P0.01）.Conclusion VitD deficiency is closely related to the incidence of childhood asthma,and supplementing the appropriate dose of VitD can improve the quality of life in children with asthma.