维生素D_(3)联合甲泼尼龙对重症哮喘患儿肺功能、炎症因子及病情复发的影响

Effects of Vitamin D_(3) Combined with Methylprednisolone on Pulmonary Function,Inflammatory Factors and Disease Recurrence in Children with Severe Asthma

目的:探究维生素D_(3)联合甲泼尼龙对重症哮喘患儿肺功能、炎症因子及病情复发的影响。方法:选取2018年4月~2019年4月本院收治的80例重症哮喘患儿作为研究对象,采用随机数字表法分为对照组(甲泼尼龙治疗)和观察组(维生素D_(3)+甲泼尼龙治疗),每组40例。比较两组临床总有效率、临床症状缓解时间、复发率及治疗前后肺功能[1 s用力呼气容积(FEV1)、1 s用力呼气容积占用力肺活量百分比(FEV1/PVC)、呼气峰值流速(PEF)日变异率]、血清25-羟基维生素D_(3)[25-(OH)D_(3)]和炎症因子[白介素-1β(IL-1β)、转化生长因子-β1(TGF-β1)、超敏C反应蛋白(hs-CRP)]水平,并观察两组不良反应发生情况。结果:观察组临床总有效率高于对照组(75.00%vs 92.50%,P<0.05),临床症状缓解时间缩短(P<0.05)。治疗后,观察组FEV1、FEV1/PVC、25-(OH)D_(3)高于对照组,PEF日变异率、IL-1β、TGF-β1、hs-CRP低于对照组(P<0.05)。随访1年,观察组复发率(10.00%)低于对照组(30.00%,P<0.05)。两组药物不良反应总发生率无统计学差异(12.50%vs 22.50%,P>0.05)。结论:维生素D_(3)联合甲泼尼龙治疗重症哮喘患儿临床疗效好,可缩短临床症状缓解时间、增强肺功能、减轻炎症反应、减少复发,且安全性良好。

Objective:To explore the effects of vitamin D_(3) combined with methylprednisolone on lung function,inflammatory factors and disease recurrence in children with severe asthma.Methods:A total of 80 children with severe asthma treated in our hospital from April 2018 to April 2019 were selected as the research subjects,and randomly divided into control group(methylprednisolone treatment)and observation group(vitamin D_(3)+methylprednisolone treatment)according to random number table,40 cases in each group.The total clinical efficacy rate,clinical symptom relief time,recurrence rate and lung function before and after treatment were compared between the two groups[forced expiratory volume in 1 s(FEV1),percentage of 1 s forced expiratory volume in forced vital capacity(FEV1/PVC),daily variation rate of peak expiratory flow(PEF)],serum 25-hydroxyvitamin D_(3)[25-(OH)D_(3)]and levels of inflammatory factors[interleukin-1β(IL-1β),transforming growth factor-β1(TGF-β1),and high sensitivity C-reactive protein(hs-CRP)]were compared.The adverse reactions of the two groups were observed.Results:The total clinical efficacy rate in the observation group was higher than that in the control group(75.00%vs 92.50%,P<0.05),and the clinical symptom relief time was shortened(P<0.05).After treatment,the upregulation degree of FEV1,FEV1/PVC and 25-(OH)D_(3) was larger than those in the control group,and the daily variation rate of PEF,IL-1β,TGF-β1 and hs-CRP in the observation group were significantly down-regulated than those in the control group(P<0.05).Follow-up of 1 year,the recurrence rate of the observation group(10.00%)was lower than that of the control group(30.00%,P<0.05).There was no significant difference in the total incidence of drug adverse reactions between the two groups(12.50%vs 22.50%,P>0.05).Conclusion:Vitamin D_(3) combined with methylprednisolone has good clinical efficacy in the treatment of children with severe asthma,which can shorten the clinical symptom relief time,enhance lung function,reduce inflammatory response and reduce recurrence with good safety.