摘要
为探讨维生素D辅助治疗学龄前儿童支气管哮喘的临床效果及作用机制,收集2014年6月—2017年12月在禹城市人民医院就诊的262例支气管哮喘患儿,按随机数字表法分为治疗A组132例和治疗B组130例。A组按GINA方案采用布地奈德混悬液雾化治疗;B组在此基础上口服星鲨维生素D滴剂,1粒/d,共治疗3个月。检测血清25-(OH)-D3、IgE、嗜酸性粒细胞阳离子蛋白(eosinophilia cationic protein,ECP)、IgA、IgM、IgG及肺功能指标,观察疗效。治疗A组和B组分别有129例和128例完成全部治疗和随访复查,其中轻、中、重度哮喘患儿的血清25-(OH)-D3、IgE及ECP水平之间差异显著(均P<0.05);治疗后B组患儿的25-(OH)-D3水平显著高于同期A组(均P<0.05);B组患儿ECP、IgE水平相比同期A组显著降低,且FVC、PEF及FEV1指标改善情况显著优于A组(均P<0.05)。在治疗过程中,B组的喘息消失时间、咳嗽和哮鸣音消失时间及3个月内哮喘发作次数均显著少于A组(均P<0.05)。治疗3个月后,治疗B组的血清免疫球蛋白水平显著高于治疗A组(均P<0.05)。Spearman相关性分析显示,两组支气管哮喘患儿的25-(OH)-D3水平与喘息消失时间、咳嗽和哮鸣音消失时间及发作次数均呈显著负相关。由此,维生素D辅助治疗学龄前儿童支气管哮喘能够有效减轻症状,提高肺功能,减少哮喘发作次数,可作为儿童支气管哮喘的重要辅助治疗手段。
In order to explore the clinical effect and mechanism of vitamin D in the adjuvant treatment of preschool children with bronchial asthma,262cases with bronchial asthma in Yucheng People's Hospital from June 2014to December 2017were collected and divided into treatment group A(132cases)and treatment group B(130cases)according to the random number table.Treatment group A was treated with budesonide suspension according to GINA regimen,while treatment group B was treated with budesonide suspension and vitamin D drops of Starshark orally,one capsule per day.After 3months of treatment,the patients were reexamined.Serum 25-(OH)-D3,IgE,eosinophilia cationic protein(ECP),IgA,IgM,IgG and pulmonary function were measured,and the recovery effect was observed.There were 129patients in treatment group A and 128patients in treatment group B who completed the whole treatment and follow-up.The serum levels of 25-(OH)-D3,IgE and ECP in mild,moderate and severe children were significantly different(all P<0.05);the levels of 25-(OH)-D3in treatment group B were significantly higher than those in treatment group A(all P<0.05).The levels of ECP and IgE in group B were significantly lower than those in group A,and the improvement of FVC,PEF and FEV1was significantly better than that in group A(all P<0.05).In the course of treatment,the disappearance time of wheezing,of cough and wheezing sound and the number of asthma attacks in treatment group B were significantly less than those in treatment group A(all P<0.05).The level of serum immunoglobulin in group B was significantly higher than that in group A(all P<0.05).Spearman correlation analysis showed that the level of 25-(OH)-D3in the two groups was significantly negatively correlated with the disappearance time of wheezing,of cough and wheezing sound,and the number of attacks.Our results suggest that vitamin D supplementation can effectively shorten the remission time of clinical symptoms,improve pulmonary function and reduce the number of asthma attacks in preschool patients.Therefor
作者
孙磊
管国涛
SUN Lei;GUAN Guo-tao(Department of Pediatrics,Yucheng People's Hospital,Yucheng 251200,China;Department of Pediatric Hematology,Shandong Provincial Hospital,Jinan 250021,China)
出处
《现代免疫学》
CAS
北大核心
2021年第4期325-330,共6页
Current Immunology
