支气管哮喘患儿血清维生素D与气道呼吸参数关系及对预后的影响

Relationship Between Serum Vitamin D and Airway and Respiratory Parameters in Children with Bronchial Asthma and Its Influence on Prognosis

目的:探究支气管哮喘(BA)患儿血清维生素D(VitD)与气道高反应性、呼吸力学参数的关系及对治疗效果的影响。方法:选取我院2018年3月至2020年8月BA患儿113例作为研究组,另选取同期健康体检儿童113例作为对照组,比较两组血清VitD水平,根据血清VitD水平将研究组分为VitD正常患儿(n=35)与VitD缺乏患儿(n=78),对比研究组VitD正常与缺乏患儿临床资料、气道高反应性[支气管激发试验(Astograph法)最小诱发累积剂量(Dmin)、血清总免疫球蛋白E(IgE)]、呼吸力学参数[气道内压(Paw)、呼吸系统黏滞阻力(R)、呼吸系统总静态顺应性(Cst)、平台压(Plat)],分析血清VitD与气道高反应性、呼吸力学参数相关性。研究组均给予常规治疗,对比研究组VitD正常与缺乏患儿治疗效果,分析血清VitD水平对BA患儿治疗效果的影响。结果:研究组血清VitD水平低于对照组(P<0.05);研究组VitD缺乏患儿Dmin、Cst低于VitD正常患儿,血清总IgE、Paw、R、Plat高于VitD正常患儿(P<0.05);血清VitD与Dmin、Cst呈正相关,与血清总IgE、Paw、R、Plat呈负相关(P<0.05);研究组VitD正常患儿治疗总有效率高于VitD缺乏患儿(P<0.05);血清VitD与BA患儿治疗效果显著相关(P<0.05)。结论:BA患儿血清VitD呈明显降低状态,且与气道高反应性、呼吸力学参数密切相关,通过补充VitD可辅助改善治疗效果,在临床诊断治疗中意义重大。

Objective:To explore the relationship between serum vitamin D(VITD)and airway hyperresponsiveness and respiratory mechanical parameters in children with bronchial asthma(BA),as well as its influence on the therapeutic effect.Methods:A total of 113 children with BA from March 2018 to August 2020 in our hospital were selected as the study group,and another 113 children for healthy physical examination during the same period were selected as the control group.The serum VitD levels of the two groups were compared.According to the serum VitD levels,the study group was divided into normal VitD children(n=35)and VitD deficient children(n=78).Clinical data,airway hyperresponsiveness[minimum induced cumulative dose(Dmin)by bronchial stimulation test(Astograph),serum total immunoglobulin E(IgE)],respiratory mechanical parameters[intraairway pressure(PAW),respiratory viscosity resistance(R),total static compliance(CST),platform pressure(PLAT)]of the children with normal and deficient VitD in the study group were compared.The correlation between serum VitD and airway hyperresponsiveness and respiratory mechanical parameters was analyzed.All the study groups were given routine treatment.The treatment effect of children with normal and deficient VitD in the study group was compared,and the influence of serum VitD level on the treatment effect of children with BA was analyzed.Results:The level of serum VitD in the study group was lower than that in the control group(P<0.05).In the study group,Dmin and CST of children with VITD deficiency were lower than those with normal VITD,and serum total IgE,PAW,R and Plat were higher than those with normal VITD(P<0.05).Serum VitD was positively correlated with Dmin and CST,and negatively correlated with serum total IgE,PAW,R and Plat(P<0.05).In the study group,the total effective rate of patients with normal VITD was higher than that of patients with VITD deficiency(P<0.05).There was a significant correlation between serum VitD and BA(P<0.05).Conclusions:The serum VITD in BA children is significantly reduced,which is closely related to airway hyperresponsiveness and respiratory mechanical parameters.Supplementation of VITD can help improve the therapeutic effect,which is of great significance in clinical diagnosis and treatment.