25二羟D3和基质金属蛋白酶9在哮喘患儿中的表达及临床意义

Expression and clinical significance of 25-dihydroxyvitamin D3 and matrix metalloproteinase-9 in children with asthma

目的探讨25二羟维生素D3[25-(OH)_2D_3]和基质金属蛋白酶9(MMP-9)在哮喘患儿中的表达及临床意义。方法回顾性选择2016年5月至2018年5月东营市胜利油田中心医院儿科收治的58例哮喘患儿作为研究对象,根据病情严重程度将其分为轻度组(n=15)与中重度组(n=43),并选择同期健康体检患儿41例作为对照组。采用酶联免疫吸附法(ELISA)测定两组患儿血清25-(OH)_2D_3、MMP-9水平及支气管肺泡灌洗液(BALF)的MMP-9水平。根据血清25-(OH)_2D_3水平将58例哮喘患儿分为维生素D(VD)缺乏组(n=36)、VD不足组(n=13)、VD正常组(n=9),比较三组患儿血清、BALF的MMP-9水平,并采用Pearson相关性来分析哮喘患儿血清25-(OH)_2D_3水平与血清MMP-9水平、BALF的MMP-9水平的相关性。结果研究组患儿血清25-(OH)_2D_3水平明显低于对照组,血清、BALF的MMP-9水平明显高于对照组,差异有统计学意义(P <0. 05)。中重度组患儿血清25-(OH)_2D_3水平明显低于轻度组,血清、BALF的MMP-9水平明显高于轻度组,差异有统计学意义(P <0. 05); VD正常组患儿血清、BALF的MMP-9水平明显低于VD不足组及VD缺乏组(P <0. 05); VD不足组患儿血清、BALF的MMP-9水平明显低于VD缺乏组(P <0. 05);哮喘患儿血清25-(OH)_2D_3水平与血清MMP-9水平呈负相关(P <0. 05),与BALF的MMP-9水平呈负相关(P <0. 05)。结论哮喘儿童血清25-(OH)_2D_3处于低水平状态,血清及BALF的MMP-9水平处于高水平状态,对哮喘临床诊断及病情程度预测有一定指导意义。

Objective To investigate the expression and clinical significance of 25-dihydroxyvitamin D3[25-(OH)2D3] and matrix metalloproteinase-9(MMP-9)in serum of children with asthma.Methods 58 children with asthma(study group)and 41 cases of health examinees(control group)admitted to our hospital from May 2016 to May 2018 were selected.The study group was further divided into two sub-groups according to severity,namely mild group(n=15)and moderate-severe group(n=43).Serum 25-(OH)2D3,MMP-9 levels and bronchoalveolar lavage fluid(BALF)MMP-9 levels were measured by ELISA.Patients in study group were re-divided into deficient vitamin D(VD)group(n=36),insufficient VD group(n=13)and normal VD group(n=9)according to serum 25-(OH)2D3 levels.Serum and BALF MMP-9 levels were compared among the three groups,and correlations with serum 25-(OH)2D3 levels were analyzed by Pearson correlation.Results The serum levels of 25-(OH)2D3 in study group were significantly lower than in control group(P<0.05).The serum and BALF MMP-9 in study group were significantly higher than in control group(P<0.05).Serum 25-(OH)2D3 levels in moderate-severe group were significantly lower than in mild group(P<0.05).Serum and BALF MMP-9 levels in moderate-severe group were significantly higher than in mild group(P<0.05).Serum and BALF MMP-9 levels:deficient VD group >insufficient VD group >normal VD group(P<0.05).Serum 25-(OH)2D3 levels were negatively correlated with serum MMP-9 levels(P<0.05)and BALF MMP-9 levels(P<0.05).Conclusion Children with asthma have lower serum 25-(OH)2D3 level as well as high serum and BALF MMP-9 levels,which has certain efficacy in child asthma diagnosis and severity prediction.