抗生素降阶梯治疗小儿重症喘息对血清维生素D的影响

Effect of de-escalation treatment of antibiotic on the serum vitamin D level in children with severe asthmatic

目的:探讨抗生素降阶梯治疗小儿重症喘息对血清维生素D的影响。方法:选择重症喘息患儿190例,根据随机抽签原则分为观察组与对照组各95例,对照组选择常规抗生素治疗,观察组采用抗生素降阶梯治疗,治疗观察时间为7 d。结果:观察组总有效率为97.9%,明显高于对照组的88.4%(P<0.01);观察组的喘息、肺部啰音消失时间与住院时间分别为(3.14±0.34)d、(4.63±0.45)d和(9.39±3.22)d,均明显短于对照组的(4.22±0.45)d、(7.82±0.56)d和(11.45±2.95)d(P<0.01);治疗后,2组患儿血清维生素25(OH)D含量分别为(53.24±9.45)ng/m L和(45.39±10.22)ng/m L,均明显高于治疗前的(28.24±9.33)ng/m L和(28.11±8.97)ng/m L(P<0.01),且观察组的上升幅度高于对照组(P<0.01)。结论:抗生素降阶梯治疗小儿重症喘息能提高血清维生素25(OH)D含量,提高总体治疗效果,促进患儿的康复。

Objective： To investigate the effects of de-escalation treatment of antibiotic on the serum vitamin D in children with severe asthmatic. Methods： One hundred and ninety children with severe asthmatic were randomly divided into the treatment group and control group according to the random draw principle（ 95 cases each group）. The control group and treatment group were treated with routine antibiotic and de-escalation of antibiotic for 7 days,respectively. Results： The total effective rate in treatment group（ 97. 9%） was significantly higher than that in control group（ 88. 4%）（ P〈0. 01）. The disappearance time of wheezing and pulmonary rale,and hospitalization time in treatment group[（ 3. 14 ± 0. 34） d,（ 4. 63 ± 0. 45） d and（ 9. 39 ± 3. 22） d] were significantly less than those in control group[（ 4. 22 ± 0. 45） d,（ 7. 82 ± 0. 56） d and（ 11. 45 ± 2. 95） d],respectively（ P〈0. 01）. The levels of serum vitamin 25（ OH） D in treatment group and control group after treatment[（ 53. 24 ± 9. 45） ng/m L and（ 45. 39 ± 10. 22） ng/m L]were significantly higher than those before treatment[（ 28. 24 ± 9. 33） ng/m L and（ 28. 11 ± 8. 97） ng/m L],respectively（ P〈0. 01）,and the increasing degree of which in treatment group was higher than that in control group（ P〈0. 01）. Conclusions： The de-escalation treatment of antibiotic in children with severe asthmatic can increase the serum vitamin 25（ OH） D content,improve the overall treatment effect,and promote the rehabilitation of children.