喀什地区学龄期儿童BA急性发作的临床特点及血清25(OH)D_(3)水平与疾病严重度的相关性

Clinical characteristics of acute attacks of BA in school-age children in Kashgar region and correlation analysis of 25(OH)D_(3)levels with disease severity

目的探讨喀什地区儿童支气管哮喘(BA)急性发作的临床特点,以及25-羟维生素D_(3)(25(OH)D_(3))水平与疾病严重度的相关性。方法选取喀什地区某三甲医院收治的6~14岁BA急性发作患儿为研究对象,根据疾病严重度(轻度、中度及重度)及血清25(OH)D_(3)水平(正常、不足及缺乏)进行分组,比较不同组的临床特征差异,分析血清(25(OH)D_(3))水平与疾病严重度的相关性。结果共纳入112例患儿,男女比例为2.61∶1,年龄为9.0(7.0,11.0)岁。112例患儿以春季发病为主,占42.9%。过敏原阳性率为74.1%(83/112),其中以吸入性过敏原为主(89.1%),树木组合阳性率最高(47.0%)。疾病严重度轻度组36例、中度组51例、重度组25例,随着疾病严重度的增加,用力肺活量(FVC)、第1秒用力呼气量(FEV_(1))、FEV_(1)与FVC的比值(FEV_(1)/FVC)逐渐下降(P<0.001);重度组嗜酸性粒细胞(EOS)百分比高于轻度组(P<0.05)。25(OH)D_(3)水平正常组28例、不足组21例、缺乏组35例;缺乏组FVC、FEV_(1)、FEV_(1)/FVC、最大呼气峰流速均低于不足组和正常组(P均<0.05);3组患儿疾病严重度比较差异有统计学意义(H=9.538,P=0.008),血清25(OH)D_(3)水平与BA急性发作的疾病严重度呈负相关(τ=-0.304,P=0.002)。结论喀什地区学龄期儿童BA急性发作高峰为春季,吸入性过敏原以树木组合为主。随着病情严重度的增加,患儿肺功能逐渐下降。血清25(OH)D_(3)水平与BA患儿肺功能及急性发作的病情严重度有相关性。

Objective To explore the clinical characteristics of acute attacks of bronchial asthma(BA)in children in Kashgar region,and analyze the impact of 25-hydroxyvitamin D_(3)(25(OH)D_(3))levels on disease severity.Methods Children with acute BA attacks,aged 6-14 years,admitted to a certain thirdtier A-level Hospital of Kashgar were enrolled and divided into different groups according to disease severity(mild,moderate and severe)and 25(OH)D_(3)levels(normal,insufficiency and deficiency).Clinical characteristics were compared among different groups.The correlation between 25(OH)D_(3)levels and disease severity was analyzed.Results A total of 112 children were enrolled,with a male-to-female ratio of 2.61∶1,with a median age of 9.0(7.0-11.0)years old.The highest incidence was found in spring(42.9%).The positive rate of allergens is 74.1%(83/112),with inhaled allergens as the main type(89.1%),and the tree combination had the highest positive rate(47.0%).Based on disease severity,36 cases were assigned into the mild group,51 cases in the moderate group,and 25 cases in the severe group.As the disease severity was aggravated,the forced vital capacity(FVC),forced expiratory volume at 1 second(FEV_(1)),and the ratio of FEV_(1)to FVC(FEV_(1)/FVC)were gradually decreased(all P<0.001).The eosinophil(EOS)count in the severe group was higher than that in the mild group(P<0.05).According to 25(OH)D_(3)levels,28 cases had normal 25(OH)D_(3)levels,21 cases with insufficient 25(OH)D_(3)levels,and 35 cases with 25(OH)D_(3)deficiency.The FVC,FEV_(1),FEV_(1)/FVC,and peak expiratory flow(PEF)in the 25(OH)D_(3)deficiency group were significantly lower than those in the insufficient and normal 25(OH)D_(3)groups(all P<0.05).The disease severity significantly differed among three groups(H=9.538,P=0.008).Serum 25(OH)D_(3)levels were negatively correlated with the severity of BA attacks(τ=-0.304,P=0.002).Conclusions Spring is the peak season of acute attacks of BA in school-age children from Kashgar.Inhaled allergens are mainly composed of tree combination.As the severity of this condition deteriorates,lung function of the affected children are gradually declined.Serum 25(OH)D_(3)levels are associated with lung function and the severity of acute attacks in children with BA.