支气管哮喘患儿血清25-羟维生素D3水平及其与肺功能、呼出气一氧化氮的关系

摘要

目的：了解支气管哮喘（简称哮喘）患儿血清25-羟维生素D3[25（OH）D3]水平及其与肺功能、呼出气一氧化氮（ FeNO）的关系，为哮喘的治疗提供新的策略。方法选取门诊6~14岁初诊哮喘患儿112例为观察组，选取同期在儿童保健科体检的6~14岁健康儿童78例为对照组，通过电化学发光法检测两组患儿血清中25（ OH）D3的含量，检测哮喘患儿呼气峰流速（ PEF）、第1秒用力呼气容积（ FEV1）、呼气峰流速占预计值百分比（ PEF％ pred ）、第1秒用力呼气容积占预计值百分比（ FEV1％ pred），对观察组患儿进行FeNO检测。对25（ OH）D3与PEF％ pred、FEV1％ pred、FeNO的相关性进行分析。结果观察组的维生素 D 缺乏、不足比例均高于对照组（χ2＝7.78，P ﹤0.01）；PEF％ pred、FEV1％ pred的值随血清25（OH）D3水平的下降而降低（F＝28.12、29.56，P均﹤0.05）， FeNO值随血清25（OH）D3水平的下降反而升高（F＝15.65，P﹤0.05）。结论维生素D缺乏或不足与儿童哮喘相关，与哮喘患儿肺功能下降有关，且可增加哮喘患儿气道炎症水平。%Objective To determine the serum 25 hydroxy vitamin D3[25(OH)D3]levels in chil-dren with bronchial asthma and its relationship with lung function,fraction of exhaled nitric oxide( FeNO). Methods Totally 112 children with asthma aged 6 years to 14 years old were selected as the study group, meanwhile 78 healthy children aged 6 years to 14 years old were selected as the control group,serum 25 ( OH)D3 was determined using the electrochemical luminescence method. Lung function was measured, which included peak expiratory flow( PEF),forced expiratory volume in one second( FEV1 ),percentage of PEF in predicted value( PEF% pred),percentage of FEV1 in predicted value( FEV1% pred). FeNO of the study group was measured. The relationship between serum 25( OH)D3 and PEF% pred,FEV1% pred,FeNO were all analyzed. Results The proportion of vitamin D deficiency and insufficiency in the study group were higher than those in the control group(χ2 =7. 78,P﹤0. 01). The values of PEF% pred and FEV1% pred were decreased with the decreasing of the 25(OH)D3 levels(F=28. 12,29. 56,P﹤0. 05),FeNO values were in-creased with the decreasing of the 25(OH)D3 levels(F=15. 65,P﹤0. 05). Conclusion Vitamin D defi-ciency or insufficiency is related to asthma in children. It is associated with the decrease of lung function,and can increase the level of airway inflammation in children with asthma.