血清维生素D、MMP-9表达水平对哮喘患儿严重程度的评估及临床意义

Clinical significance of serum levels of vitamin D and matrix metalloproteinase-9 in evaluating severity of asthma in children

目的探讨血清维生素D、基质金属蛋白酶-9(MMP-9)表达水平对哮喘患儿严重程度的评估价值。方法选择2018年8月至2019年8月成都市妇女儿童中心医院呼吸科门诊收治入院的56例哮喘急性发作期患儿作为研究对象,根据病情严重程度将患儿分为轻度组14例、中度组25例、重度组17例,选择同期在我院儿保科体检合格的34例儿童作为对照组。所有受试对象入组后24 h内抽取静脉血测定血清中维生素D及MMP-9水平,并进行肺功能检查。比较四组研究对象的一般情况、肺功能指标、血清中维生素D及MMP-9水平,对血清中维生素D、MMP-9水平与肺功能和病情严重程度进行相关性分析。结果患儿第1 s用力呼气容积(FEV1)、用力肺活量(FVC)、FEV1/FVC、25%用力呼气流量(FEF25)、50%用力呼气流量(FEF50)及75%用力呼气流量(FEF75)明显小于对照组(P<0.05);随着病情程度加重,FEV1、FVC、FEV1/FVC、FEF25、FEF50及FEF75逐渐减小(P<0.05);患儿血清中维生素D水平明显低于对照组,血清中MMP-9水平明显高于对照组(P<0.05);随着病情程度加重,血清中维生素D水平逐渐降低,血清中MMP-9水平逐渐升高(P<0.05);血清中维生素D水平与FEF25、FEF50及FEF75呈正相关,血清中MMP-9水平与FEF25、FEF50及FEF75呈负相关(P<0.05);血清中维生素D水平与病情严重程度呈负相关;血清中MMP-9水平与病情严重程度呈正相关。结论哮喘患儿血清中维生素D水平随病情程度逐渐下降,MMP-9水平随病情程度逐渐上升,同时其水平与肺功能密切相关,加强对哮喘患儿血清维生素D及MMP-9的监测对病情评估具有重要的临床意义。

Objective To investigate the value of serum levels of vitamin D and matrix metalloproteinase-9( MMP-9) in evaluating the severity of asthma in children. Methods A total of 56 children with acute asthma attacks and 34 healthy children( the control group) in Chengdu Women’ s & Children’ s Central Hospital from August 2018 to August 2019 were enrolled in this study. And the asthma children were divided into three groups according to the severity degrees: a mild group( n = 14),a moderate group( n = 25),and a severe group( n = 17). The general condition,lung function indexes,serum vitamin D and MMP-9 levels of the four groups were collected and compared,and the correlation between the serum vitamin D and MMP-9 levels and the lung function and severity was analyzed. Results The forced expiratory volume in one second( FEV1),the forced vital capacity( FVC),FEV1/FVC,the forced expiratory flow at 25%( FEF25),the forced expiratory flow at 50%( FEF50) and the forced expiratory flow at 75%( FEF75) of the asthma children were significantly lower than those of the control group( P<0.05). As the severity of the disease increased,the FEV1,FVC,FEV1/FVC,FEF25,FEF50 and FEF75 gradually decreased( P<0.05). The serum vitamin D level in the asthma children was significantly lower than that of the control group and the serum MMP-9 level was significantly higher than that of the control group( P<0.05). As the severity of the disease increased,the level of vitamin D in serum gradually decreased and the level of MMP-9 in serum increased gradually( P<0.05). The FEF25,FEF50 and FEF75 were positively correlated with the serum vitamin D level and negatively correlated with the MMP-9 level( P < 0. 05). The severity of the disease was negatively correlated with the serum vitamin D level and positively correlated with the MMP-9 level( P< 0.05). Conclusion In asthma children,the serum vitamin D level is decreased and the MMP-9 level is increased as the severity of the disease increases.Moreover,the two levels are closely related to the lung function,which has high clinical signficance.