维生素D3联合丙酸氟替卡松、沙丁胺醇对咳嗽变异性哮喘患儿肺功能及气道炎症反应的影响

Effects of Vitamin D3 Combined with Fluticasone Propionate and Salbutamol on Lung Function and Airway Inflammation in Children with Cough Variant Asthma

目的探讨维生素D_(3)联合丙酸氟替卡松、沙丁胺醇治疗咳嗽变异性哮喘(CVA)患儿的临床效果。方法选取永城市人民医院2019年8月至2020年8月收治的86例CVA患儿,根据随机数字表法分为两组(试验组43例、参照组43例),两组均接受常规抗感染治疗,参照组接受丙酸氟替卡松、沙丁胺醇治疗,试验组在参照组基础上联合维生素D_(3)治疗。比较两组临床疗效,治疗前、治疗1个月后肺功能指标[用力肺活量(FVC)、第1秒用力呼气容积(FEV_(1))、呼气峰值流速(PEF)、最大呼气中段流量(MMEF)]水平,血清炎症因子[白细胞介素-5(IL-5)、肿瘤坏死因子-α(TNF-α)、免疫球蛋白E(IgE)]水平,T淋巴细胞亚群[CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+)]及25-羟基维生素D_(3)[(25-(OH)-D_(3))]水平。结果与参照组治疗总有效率(81.40%)相比,试验组(95.35%)较高(P<0.05);与参照组相比,治疗1个月后试验组FVC、FEV_(1)、PEF、MMEF较高,血清IL-5、TNF-α、IgE水平较低,与治疗前相比,治疗后试验组、参照组FVC、FEV_(1)、PEF、MMEF较高,血清IL-5、TNF-α、IgE水平较低(P<0.05);与参照组相比,治疗1个月后试验组CD4^(+)、CD4^(+)/CD8^(+)水平较低,CD8^(+)、25-(OH)-D_(3)水平较高,与治疗前相比,治疗后试验组、参照组CD4^(+)、CD4^(+)/CD8^(+)水平较低,CD8^(+)、25-(OH)-D_(3)水平较高(P<0.05)。结论维生素D_(3)联合丙酸氟替卡松、沙丁胺醇治疗CVA患儿效果显著,可有效改善肺功能及免疫功能,抑制机体炎症因子释放。

Objective To investigate the clinical effect of vitamin D_(3) combined with fluticasone propionate and salbutamol in children with cough variant asthma(CVA).Methods Eighty-six children with CVA in Yongcheng People’s Hospital from August 2019 to August 2020 were selected and divided into two groups(43 cases in the experimental group and 43 cases in the reference group)according to random number table.Both groups received routine for anti-infective treatment,the reference group recei ved fluticasone propionate and salbutamol,and the experimental group received vitamin D_(3) on the basis of the reference group.The clinical efficacy,lung function indexes[forced vital capacity(FVC),forced expiratory volume in the first second(FEV:),peak expiratory flow(PEF),maximum mid-expiratory flow(MMEF)]levels,serum inflammatory factors[interleukin-5(IL-5),tumor necrosis factor-α(TNF-α),immunoglobulin E(IgE)]levels,T lymphocyte subsets[CD4^(+),CD8^(+),CD4^(+)/CD8^(+)]and 25-hydroxyvitamin D_(3)[(25-(0H)-D_(3))]levels before treatment and 1 month after treatment between the two groups were compared.Results Compared with the total effective rate of treatment in reference group(81.40%),the experimental group(95.35%)was higher(P<0.05).Afer 1 month of treatment,compared with the reference group,the levels of FVC,FEV,PEF,MMEF in the experimental group were higher,and the levels of serum IL-5,TNF-α,IgE were lower.Compared with before treatment,FVC,FEVI,PEF and MMEF in experimental group and reference group after treatment were higher,while serum IL-5,TNF-a and IgE levels were lower(P<0.05).After 1 month of treatment,compared with the reference group,the levels of CD4^(+),CD4^(+)/CD8^(+)in experimental group were lower,and the levels ofCD8^(+),25-(0H)-D_(3) were higher.Compared with before treatment,the levels of CD4^(+)and CD4^(+)/CD8^(+)in the experimental group and the reference group after treatment were lower,while the levels of CD8^(+)and 25-(0H)-D_(3) were higher(P<0.05).Conclusion Vitamin D_(3) combined with fluticasone propionate and salbutamol are effective in treating children with CVA,which can efectively improve lung function and immune function,and inhibit the release of inflammatory factors in the body.