支原体肺炎合并哮喘患儿血清维生素D水平与T淋巴细胞亚群及肺功能的相关性研究

Correlation between vitamin D level and T lymphocyte subsets and lung function in children with Mycoplasma pneumoniae pneumonia combined with asthma

目的:探讨支原体肺炎(MPP)合并哮喘患儿血清维生素D水平与T淋巴细胞亚群及肺功能的相关性。方法:选择2015年8月至2018年6月本院收治的MPP合并哮喘患儿134例为MPP合并哮喘组,根据哮喘严重程度分级分为轻度组、中度组和重度组,另采用分层抽样的方法选择本院同期收治的未合并哮喘的MPP患儿134例为单纯MPP组,134例健康儿童为健康对照组,比较3组血清1,25-二羟维生素D3[1,25(OH)2D3]、T淋巴细胞亚群水平及肺功能,分析1,25(OH)2D3水平与T淋巴细胞亚群及肺功能指标的相关性。结果:MPP合并哮喘组1,25(OH)2D3、用力肺活量(FVC)、第1秒用力呼气容积(FEV1)、呼气峰流速(PEF)、CD3^+、CD4^+及CD4^+/CD8^+低于单纯MPP组、健康对照组,单纯MPP组低于健康对照组,差异均有统计学意义(P<0.05);MPP合并哮喘组CD8^+高于单纯MPP组、健康对照组,单纯MPP组高于健康对照组,差异均有统计学意义(P<0.05)。重度组血清1,25(OH)2D3水平及FVC、FEV1、PEF、CD3^+、CD4^+、CD4^+/CD8^+低于中度组、轻度组,中度组低于轻度组,差异均有统计学意义(P<0.05);重度组CD8^+高于中度组、轻度组,中度组高于轻度组,差异均有统计学意义(P<0.05)。MPP合并哮喘组1,25(OH)2D3水平与FVC、FEV1、PEF、CD3^+、CD4^+及CD4^+/CD8^+呈正相关(P<0.05),与CD8^+呈负相关(P<0.05)。结论:MPP合并哮喘患儿血清1,25(OH)2D3水平显著降低,与T淋巴细胞亚群及肺功能指标密切相关,监测血清1,25(OH)2D3水平有助于MPP合并哮喘患儿的临床诊疗。

Objective: To explore the correlation between vitamin D level and T lymphocyte subsets and lung function in children with Mycoplasma pneumoniae pneumonia( MPP) combined with asthma. Methods: 134 cases of children with MPP combined with asthma who were admitted to our hospital from August 2015 to June 2018 were randomly selected as MPP combined with asthma group. According to the severity of asthma,asthma patients were divided into mild group,moderate group and severe group. Another 134 MPP children without asthma who were admitted to our hospital in the same period were selected as MPP group by stratified sampling. 134 healthy children were selected as healthy control group. The levels of 1,25-dihydroxyvitamin D3[1,25(OH)2D3],T lymphocyte subsets and lung function were compared between the three groups. The correlation between 1,25(OH)2D3 level and T lymphocyte subsets and lung function indexes were analyzed. Results: The levels of 1,25(OH)2D3,forced vital capacity( FVC),first second forced expiratory volume( FEV1),peak expiratory flow( PEF),CD3^+,CD4^+ and CD4^+/CD8^+ in MPP combined with asthma group were lower than those in MPP group and healthy control group,but those in MPP group were lower than those in healthy control group( P < 0. 05). The CD8^+ in MPP combined with asthma group was higher than that in MPP group and healthy control group,that in MPP group was higher than that in healthy control group( P < 0. 05). The serum levels of 1,25(OH)2D3,FVC,FEV1,PEF,CD3^+,CD4^+ and CD4^+/CD8^+ in severe group were lower than those in moderate group and mild group,those in moderate group was lower than those in mild group( P < 0. 05). The serum level of CD8+in severe group was higher than that in moderate group and mild group,that in moderate group was higher than that in mild group( P < 0. 05). The level of 1,25(OH)2D3 was positively correlated with FVC,FEV1,PEF,CD3^+,CD4^+ and CD4^+/CD8^+ in MPP combined with asthma group( P < 0. 05),and it was negatively correlated with CD8^+( P < 0. 05). Conclusion: The serum level of 1,25(OH)2D3 in MPP combined with asthma children is significantly decreased,which is closely related to T lymphocyte subsets and pulmonary function. Monitoring serum 1,25(OH)2D3 level is helpful for clinical diagnosis and treatment of children with MPP combined with asthma.