支气管哮喘患儿血清25-(OH)D_(3)与肺功能、FeNO及MMP-9的关系

Relationship between serum 25-(OH) D_(3) level and pulmonary function,FeNO,MMP-9 levels in children with bronchial asthma

目的分析支气管哮喘患儿血清25-羟维生素D_(3)[25-(OH)D_(3)]与呼出气一氧化氮(FeNO)、肺功能指标[用力肺活量(FVC)、第1秒最大呼气量(FEV1)、第1秒最大呼气量与用力肺活量百分比(FEV1/FVC%),第1秒用力呼气容积占预计百分比(FEV1%pred)]、基质金属蛋白酶9(MMP-9)的关系,为小儿支气管哮喘诊治及预后提供参考。方法选择该院儿科2016年6月至2019年6月诊治的116例支气管哮喘患儿为研究组,另选取同期体检的120例健康儿童作为健康组。比较研究组与健康组的25-(OH)D_(3)、FeNO、MMP-9及FEV1/FVC%、FEV1%pred指标,比较不同严重程度支气管哮喘患儿25-(OH)D_(3)、FEV1/FVC%、FEV1%pred、FeNO、MMP-9,采用Pearson相关分析患儿25-(OH)D_(3)与FEV1/FVC%、FEV1%pred、FeNO、MMP-9的相关性。结果研究组25-(OH)D_(3)、FEV1%pred、FeNO低于健康组,而MMP-9高于健康组,差异有统计学意义(P<0.05),两组FEV1/FVC%比较,差异无统计学意义(P>0.05)。不同严重程度支气管哮喘患儿25-(OH)D_(3)、FEV1%pred、FeNO、MMP-9比较,差异有统计学意义(P<0.05),而其FEV1/FVC%比较,差异无统计学意义(P>0.05)。Pearson相关分析显示,支气管哮喘患儿25-(OH)D_(3)与FEV1/FVC%无相关关系(P>0.05),与FEV1%pred呈显著正相关(r=0.800,P<0.05),与FeNO和MMP-9呈显著负相关(r=—0.756、—0.760,P<0.05)。结论支气管哮喘患儿25-(OH)D_(3)与FEV1%pred、FeNO和MMP-9关系密切,25-(OH)D_(3)与支气管哮喘患儿病情发展存在关联,对其诊断及治疗时应注意监测25-(OH)D_(3)。

Objective To study the relationship between serum 25-hydroxyvitamin D_(3)[25-(OH)D_(3)]levels and lung function indicators(FEV1/FEV1/FVC%,FEV1%pred),exhaled nitric oxide(FeNO)and matix metallo proteinase 9(MMP-9)levels in children with bronchial asthma for providing a reference for the diagnosis,treatment and prognosis of bronchial asthma in children.Methods A total of 116 children with bronchial asthma diagnosed and treated in the First Affiliated Hospital of Xi′an Jiaotong University School of Medicine from June 2016 to June 2019 were selected in study group,and 120 healthy children with physical examination at the same period were selected as health group.The 25-(OH)D_(3),FeNO,MMP-9 and lung function indexes levels between study group and healthy group,which in children with bronchial asthma of different severity were compared,and Pearson correlation was used to analyze the correlations between 25-(OH)D_(3) and FEV1/FVC%,FEV1%pred,FeNO,MMP-9.Results 25-(OH)D_(3),FEV1%pred and FeNO in study group were lower than those in healthy group,while MMP-9 was higher than that in healthy group,the differences were statistically significant(P<0.05).There was no significant difference on FEV1/FVC%between study group and healthy group(P>0.05).The differences on 25-(OH)D_(3),FEV1%pred,FeNO and MMP-9 in children with different severity of bronchial asthma were statistically significant(P<0.05),however there was no significant difference on FEV1/FVC%(P>0.05).Pearson correlation analysis showed that 25-(OH)D_(3) in children with bronchial asthma had no correlation with FEV1/FVC%(P>0.05),but had a significant positive correlation with FEV1%pred(r=0.800,P<0.05),had significant negatively correlation with FeNO and MMP-9(r=—0.756,—0.760,P<0.05).Conclusion 25-(OH)D_(3) in children with bronchial asthma closely relates to FEV1%pred,FeNO and MMP-9,25-(OH)D_(3) associates with the disease development of children with bronchial asthma,and attention should be paid to monitoring 25-(OH)D_(3) in its diagnosis and treatment.