哮喘患儿呼出气一氧化氮、1,25-二羟维生素D_3及儿童哮喘控制测试评分与肺功能的相关性

Correlation between FeNO,1,25(OH)_2D_3,C-ACT Scores and Pulmonary Function in Children with Asthma

目的:探讨哮喘患儿呼出气一氧化氮(FeNO)、1,25-二羟维生素D_3[1,25(OH)_2D_3]及儿童哮喘控制测试(C-ACT)评分与肺功能的相关性。方法:选取2017年6月～2018年6月在我院就诊的86例哮喘患儿作为观察组,另选取同期于我院进行健康检查的86例健康儿童作为对照组。比较两组受试儿童1,25(OH)_2D_3浓度、FeNO、一秒用力呼气容积(FEV1)、呼气流量峰值(PEF)水平,比较不同病情哮喘患儿1,25(OH)_2D_3浓度、FeNO、C-ACT、FEV1、PEF水平,并分析哮喘患儿1,25(OH)_2D_3、FeNO、C-ACT与肺功能的相关性。结果:观察组1,25(OH)_2D_3浓度、FEV1、PEF水平低于对照组(P<0.05),FeNO水平高于对照组(P<0.05);随着病情加重,1,25(OH)_2D_3浓度、PEF、FEV1水平、C-ACT评分均逐渐下降,FeNO水平逐渐升高,不同病情患儿间比较差异均有统计学意义(P<0.05)。哮喘患儿1,25(OH)_2D_3与FEV1、PEF呈正相关(r=0.912、0.873,P=0.006、0.008);C-ACT与FEV1、PEF呈正相关(r=0.472、0.366,P=0.036、0.032);FeNO与FEV1、PEF无相关(r=-0.035、-0.124,P=0.075、0.064)。结论:哮喘患儿1,25(OH)_2D_3浓度、C-ACT评分明显降低,FeNO水平明显升高,1,25(OH)_2D_3、C-ACT评分与肺功能呈正相关,但FeNO与肺功能无相关,C-ACT可用于哮喘患儿病情的预测,同时,通过提高患儿体内1,25(OH)_2D_3浓度可以改善其肺功能。

Objective: To explore the correlation between fractional exhaled nitric oxide(FeNO), 1, 25-dihydroxyvitamin D3[1,25(OH)2D3], children asthma control test(C-ACT) scores and pulmonary function in children with asthma. Methods: 86 children with asthma in our hospital from June 2017 to June 2018 were selected as the observation group, and another 86 healthy children who were received physical examination in our hospital during the same period were selected as control group. The concentrations of 1, 25(OH)2D3,levels of FeNO, forced expiratory volume in one second(FEV1) and peak expiratory flow(PEF) were compared between the two groups.The concentrations of 1,25(OH)2D3, levels of FeNO, C-ACT, FEV1 and PEF in children with different stages of disease were compared.The correlation between 1,25(OH)2D3, FeNO, C-ACT and pulmonary function in children with asthma was analyzed. Results: The concentration of 1,25(OH)2D3 and the levels of PEF, FEV1 in observation group were significantly lower than those of the control group(P<0.05), while the level of FeNO was significantly higher ower than that of the control group(P <0.05). With the aggravation of the patient’s condition, the concentrations of 1,25(OH)2D3, levels of PEF, FEV1, C-ACT scores were decreased gradually, while the level of FeNO was increased gradually, and the differences were statistically significant between children in different status(P<0.05). 1,25(OH)2D3 in children with asthma was positively correlated with FEV1, PEF(r=0.912, 0.873, P=0.006, 0.008). C-ACT was positively correlated with FEV1, PEF(r=0.472, 0.366, P=0.036, 0.032). FeNO was not correlated with FEV1, PEF(r=-0.035,-0.124, P=0.075, 0.064).Conclusion: The concentrations of 1,25(OH)2D3 and C-ACT scores in children with asthma are significantly decreased, and the level of FeNO is increased significantly. 1, 25(OH)2D3 and C-ACT scores are positively correlated with lung function, but FeNO is not correlated with lung function. C-ACT can be used to predict the condition of children with asthma, at the same time, lung function of children with asthma can be improved by increasing the concentration of 1,25(OH)2D3.