哮喘患儿血清中维生素D3水平对哮喘控制和肺功能的影响及其临床意义

Effects of serum vitamin D3 level on asthma control and pulmonary function in children with asthma and their clinical significances

目的:探讨不同控制水平哮喘患儿血清中25羟维生素D3(简称维生素D3)水平的差异,分析哮喘患儿血清中维生素D3水平与肺功能指标的相关性,阐明维生素D3水平对哮喘控制和肺功能的影响。方法:选取64例6~14岁哮喘患儿作为哮喘组,根据哮喘控制水平情况再分为良好控制组、部分控制组和未控制组,同时选取同年龄段健康体检儿童作为对照组18人。收集研究对象的一般资料,应用罗氏电化学发光法检测2组研究对象血清中维生素D3水平;应用肺功能仪检测肺功能指标,包括用力肺活量(FVC)、第1秒最大呼气量(FEV1)、第1秒用力呼气容积占预计值的百分比(FEV1%pred)和第1秒最大呼气率(FEV1/FVC%)。采用Wilcoxon秩和检验分析哮喘组和对照组研究对象血清中维生素D3水平,应用Kruskal-Wallis检验分析不同控制水平组患儿维生素D3水平差异,采用Spearman相关分析法分析维生素D3水平与哮喘患儿肺功能指标的关系。结果:哮喘组患儿血清中维生素D3水平明显低于对照组(P<0.05);哮喘良好控制组患儿血清中维生素D3水平高于未控制组(P<0.05),但部分控制组患儿血清中维生素D3水平与良好控制组和未控制组比较差异无统计学意义(P>0.05);维生素D3缺乏患儿在未控制组比例明显高于良好控制组(P<0.05)。维生素D3水平与FEV1和FEV1/FVC%呈正相关关系(r=0.651,P<0.01;r=0.642,P<0.01)。结论:哮喘患儿血清中维生素D3水平影响哮喘控制水平和肺功能,在哮喘治疗过程中应高度重视维生素D3不足或缺乏,补充维生素D3有望成为哮喘辅助治疗的重要手段。

Objective:To explore the differences in the levels of 25 hydroxy vitamin D3(vitamin D3)of the asthmatic children with different control levels,to analyze the relationships between the vitamin D 3 level and the pulmonary function indexes,and to clarify the effects of vitamin D3 level on the asthma control and the pulmonary function.Methods:A total of 64 asthmatic patients who aged from 6 to 14 years old were selected as asttma group,and then according to the control level,asthma groups were divided into well-controlled group,partially controlled group and uncontrolled group.Eighteen healthy children who aged from 6 to 14 years old were selected as control group.The general materials of subjects in gwo groups were collected.The levels of serum vitamin D3 of the subjects in two groups were detected by Roche electrochemiluminescence,and the pulmonary function indexes(FEV1,FEV1%pred,FEV1/FVC%,and FVC)were measured by spirometry.The levels serum of vitamin D3 of the subjects in asthma and control groups were analyzed by Wilcoxon rank sum test,the differences of vitamin D3 levels among different control level groups were analyzed by Kruskal-Wallis test,and the relationships between the vitamin D3 level and the pulmonary function indexes were analyzed by Spearman correlation analysis.Results:The serum vitamin D3 level of the children in asthma group was significantly lower than that in control group(P<0.05).The level of serum vitamin D3 of the children in well-controlled group was higher than that in uncontrolled group(P<0.05),but the level of serum vitamin D3 of the children in partially controlled group had no differences neither with well-controlled group nor with uncontrolled group(P>0.05).The percentage of children with vitamin D3 deficiency in uncontrolled group was significantly higher than that in well-controlled group(P<0.05).The vitamin D3 level was positively correlated with FEV1 and FEV1/FVC%(r=0.651,P<0.01;r=0.642,P<0.01).Conclusion:The level of serum vitamin D3 of the asthmatic children affects the control level of asthma and pulmonary function,so vitamin D3 inefficiency or deficiency should be paid attention in the treatment of asthma.Vitamin D3 supplementation is expected to be an important means of adjuvant treatment for asthma.