儿童哮喘治疗中补充维生素D制剂的应用价值

Application value of vitamin D supplement in treatment of childhood asthma

目的探讨儿童哮喘治疗中补充维生素D制剂的应用价值。方法将136例急性发作期哮喘患儿按随机数字表法分为观察组和对照组,每组68例。两组均给予常规治疗,观察组在常规治疗基础上给予维生素D滴剂800 IU/d口服。治疗12周时,采用儿童哮喘控制测试量表(C-ACT)评价两组患儿哮喘控制情况;比较两组患儿治疗前和治疗12周时第1秒用力呼气容积占预计值百分比(FEV1%)、用力肺活量占预计值百分比(FVC%)以及血清25-(OH) D、总免疫球蛋白E(Ig E)和嗜酸细胞阳离子(ECP)水平的变化。结果治疗12周时,观察组和对照组哮喘控制率分别为88.2%和75.0%,差异有统计学意义(P <0.05),两组患儿FEV1%和FVC%的改善情况差异无统计学意义(P> 0.05)。两组血清总Ig E和ECP水平均较治疗前显著下降(P <0.01),但观察组显著低于对照组(P <0.05)。两组患儿均未发现明显的药物相关性不良反应。结论短期小剂量补充维生素D制剂在一定程度上可降低哮喘患儿血清Ig E和ECP水平,有利于提高临床控制率,且安全性较好。

Objective To explore the application value of vitamin D supplement in treatment of childhood asthma.Methods One hundred and thirty-six children with acute asthma were randomly divided into observation group(n = 68) and control group(n = 68).The children in both groups were given routine treatment of asthma,while the children in the observation group were given vitamin D drops 800 IU/d orally on the basis of the routine treatment.After 12 weeks of treatment,the Children’s Asthma Control Test(C-ACT) was used to evaluate asthma control in both groups.The percentages of forced expiratory volume in the first second(FEV1%) and forced vital capacity(FVC%)before and 12 weeks after treatment were compared between the two groups and the changes of serum 25-(OH) D,total Ig E and eosinophil cationic protein(ECP) levels were also compared.Results After 12 weeks of treatment,the asthma control rate was 88.2% in the observation group and 75.0% in the control group(P < 0.05),but there were no significant differences in the improvements of FEV1% and FVC% between the two groups(P > 0.05).The levels of serum total Ig E and ECP in both groups after treatment were significantly lower than those before treatment(P <0.01),but those in the observation group were significantly lower than those in the control group(P < 0.05).No obvious drug-related adverse reactions were found in the two groups.Conclusion Short-term and low-dose vitamin D supplement may reduce the serum Ig E and ECP levels in asthmatic children to some extent.It is beneficial to improve the clinical control rate and has good safety.