维生素D3辅助治疗咳嗽变异性哮喘患儿的疗效观察

Efficacy of Vitamin D3 Assisted Therapy on Children Patients with Cough Variant Asthma

目的探讨维生素D3辅助治疗对咳嗽变异性哮喘(coughvariantasthma,CVA)患儿的疗效。方法随机分配122例CVA患儿为对照组和观察组,各61例。对照组给予丙酸氟替卡松+硫酸沙丁胺醇吸入治疗,观察组基于对照组治疗基础上给予维生素D3,对比2组治疗前及治疗6个月后的临床症状、肺功能、T淋巴细胞亚群含量和25羟维生素D3[25-dihydroxy vitamin D3,25(OH)D3]、基质金属蛋白酶9(matrix metalloproteinase 9,MMP-9)、白细胞介素-10 (interleukin-10,IL-10)。结果与治疗前比较,治疗后2组临床症状评分显著降低(P<0.05),肺功能指标中第1秒末用力呼气量、肺活量及呼气峰流速百分比显著提高(P<0.05),观察组变化幅度显著大于对照组;治疗后,观察组CD4^+及CD4^+/CD8^+含量显著低于治疗前及对照组(P<0.05),CD8^+含量显著高于治疗前及对照组(P<0.05);治疗后,2组患儿血清25(OH)D3、IL-10水平升高(P<0.05),MMP-9水平显著降低(P<0.05),观察组变化幅度显著大于对照组(P<0.05);2组患儿均未见有明显不良反应。结论维生素D3联合常规疗法可明显改善CVA患儿咳嗽等症状,提高肺功能,纠正T淋巴细胞亚群失衡,改善气道高反应及气道炎性反应,安全性良好。

OBJECTIVE To explore the efficacy of vitamin D3 assisted therapy on children patients with cough variant asthma(CVA). METHODS The 122 cases of CVA children patients were randomly divided into control group(n=61) and observation group(n=61). Control group was given fluticasone propionate inhalation aerosol + salbutamol sulfate inhalation aerosol, and observation group was given vitamin D3 on the basis of control group. The clinical symptoms, lung function, T lymphocyte subsets contents and serum 25-dihydroxy vitamin D3[25(OH)D3], matrix metalloproteinase 9(MMP-9), interleukin-10(IL-10) before treatment and after 6 months of treatment were compared between the two groups. RESULTS Compared with before treatment, the clinical symptoms scores in the two groups were significantly decreased(P<0.05), and the lung function indexes of forced expiratory volume in one second, forced vital capacity and peak expiratory flow rate in the two groups were increased(P<0.05), and the changes in observation group were significantly greater than those in control group(P<0.05). After treatment, the CD4^+ and CD4^+/CD8^+ in observation group were significantly lower than those before treatment and those in control group(P<0.05) while the CD8^+ was significantly higher than that before treatment and that in control group(P<0.05). After treatment, the levels of serum 25(OH)D3 and IL-10 in the two groups were increased(P<0.05) while the level of MMP-9 was significantly decreased(P<0.05), and the changes in observation group were greater than those in control group(P<0.05). There were no obvious adverse reactions in the two groups. CONCLUSION Vitamin D3 combined with routine therapy can significantly improve the cough symptoms in children patients with CVA, improve lung function, correct the imbalance of T lymphocyte subsets, and promote airway hyperresponsiveness and airway inflammatory response, and it has good safety.