两种不同雾化吸入糖皮质激素法治疗支气管哮喘的预后及与维生素D水平变化的相关性

Correlation Between Prognosis and Vitamin D Level of Two Different Aerosol Inhalation Glucocorticoids in the Treatment of Bronchial Asthma

目的探讨两种不同雾化吸入糖皮质激素法治疗支气管哮喘的预后及与维生素D水平变化的相关性。方法选取2017年12月~2020年12月喀什地区第一人民医院收治的80例支气管哮喘患者为研究对象,将患者按照随机数表法分为观察组和对照组,每组40例。对照组患者经口吸入糖皮质激素,观察组患者经面罩吸入糖皮质激素,比较两组患者的治疗效果,比较两组患者憋喘消失时间、哮鸣音消失时间以及咳嗽消失时间,并对比治疗显效患者、有效患者和无效患者治疗前维生素、白细胞介素-4(IL-4)、IL-5和IL-17表达水平,并分析维生素D水平与支气管哮喘的预后相关性。结果观察组患者治疗总有效率高于对照组,差异具有统计学意义(P<0.05);观察组患者憋喘消失时间、哮鸣音消失时间及咳嗽消失时间均短于对照组,差异均具有统计学意义(P<0.05);治疗显效者、有效者、无效者性别、年龄、BMI经比较,差异无统计学意义(P>0.05),治疗显效者、有效者、无效者治疗前血清维生素D3、IL-4、IL-5和IL-17水平经比较,差异具有统计学意义(P<0.05);Pearson相关分析结果显示,治疗前血清维生素D3与治疗控制程度呈负相关(P<0.05),IL-4、IL-5、IL-17水平与治疗控制程度呈正相关(P<0.05)。结论对支气管哮喘患者采取经面罩吸入糖皮质激素治疗,能够更有效地控制病情,缩短患者临床症状持续时间。另外,治疗前患者血清维生素D3、IL-4、IL-5、IL-17水平与病情控制程度具有明显相关性,因此可以考虑在检测IL-4、IL-5、IL-17常规炎性因子基础上增加维生素D水平检测以判断患者的预后情况。

Objective To investigate the correlation between the prognosis of bronchial asthma and the changes of vitamin D levels by two diff erent nebulized glucocorticoid methods.Methods A total of 80 patients with bronchial asthma treated in the fi rst people’s Hospital of Kashgar region from December 2017 to December 2020 were selected.The patients were divided into two groups according to the random number table method,with 40 patients in each group.The patients in the control group were given oral inhaled glucocorticoids,and the patients in the observation group were given inhaled glucocorticoids through a mask.The treatment eff ects of the two groups were compared,and the disappearance time of wheezing,wheezing and cough in the two groups were compared and analyzed,The expression levels of vitamin D,IL-4(interleukin-4),IL-5 and IL-17 were compared among signifi cantly eff ective patients,eff ective patients and ineff ective patients before treatment,and the correlation between vitamin D level and the prognosis of bronchial asthma was analyzed.Results The total eff ective rate of the observation group was 95.00%,and that of the control group was 77.50%,which was signifi cantly higher in the observation group than in the control group(P<0.05);The disappearance time of wheezing,wheezing and cough in the observation group were signifi cantly shorter than those in the control group(P<0.05);There was no signifi cant diff erence in sex,age and BMI among the signifi cantly eff ective,eff ective and ineff ective patients(P>0.05).There was signifi cant diff erence in serum vitamin D3,IL-4,IL-5 and IL-17 among the significantly effective,effective and ineffective patients before treatment(P<0.05);Pearson correlation analysis showed that serum vitamin D3 was negatively correlated with the degree of treatment control(P<0.05),and IL-4,IL-5,IL-17 were positively correlated with the degree of treatment control(P<0.05).Conclusion Inhaled glucocorticoids through a mask for patients with bronchial asthma can more eff ectively control the disease and shorten the duration of clinical symptoms.In addition,the serum vitamin D3 level,IL-4,IL-5 and IL-17 of patients before treatment are signifi cantly correlated with the degree of disease control.Therefore,it can be considered to increase the vitamin D level on the basis of routine infl ammatory factors of IL-4,IL-5 and IL-17 to judge the prognosis of patients.