维生素D预防儿童急性呼吸道感染诱导哮喘发作的研究

摘要

目的：研究维生素D对于儿童急性呼吸道感染诱导哮喘发作的预防效果及安全性。方法选择2009年11月～2013年5月收治的188例哮喘缓解期患儿作为研究对象，将所有患儿按照随机分组原则分为试验组A （94例）与试验组B（94例），两组患者均采用常规缓解哮喘药物，试验组B除上述治疗外哮喘发作前不予任何干预，试验组A在上述基础上每日服用罗钙全胶囊作为预防措施，两组随访2周观察随访期间哮喘发作情况，比较哮喘发作严重程度。另外选取30例体检健康的儿童作为对照，检测治疗前所有患者的维生素D水平及对照组维生素D水平，比较治疗前、后维生素D水平差异。结果试验组A哮喘发作者24例，其中轻度18例，中度6例，无重度者；试验组B哮喘发作56例，其中轻度24例，中度21例，重度9例；两组发病率具有显著差异性，P＜0.05；治疗前试验组A、B维生素D水平无显著差异同对照组相比显著低，治疗后试验组A维生素D水平显著上升，同对照组无明显差异性，试验组B同治疗前无明显变化。结论维生素D水平的缺乏可能是哮喘的重要原因，通过积极补充维生素D水平可以降低急性呼吸道感染诱发哮喘发作的发病率。%Objective To study the effect and safety of vitamin D in the prevention of children asthma attack induced by acute respiratory infection.Methods A total of 188 children with asthma in remission stage admitted to our hospital from November 2009 to May 2013 were selected as the subject , who were randomized into experiment group A (94) and experiment group B (94).Both two groups received conventional asthma -relieving drugs.On the basis above, group B received no intervention , group B received rocaltrol capsules as preventive measure.A two-week follow-up observation was conducted to observe the asthma attacks of two groups to compare the severity of asthma attacks .In addition, 30 healthy children were selected as control.Before the treatment , the vitamin D levels of experimental groups and control group were detected to compare the difference between the vitamin D levels before and after treatment .Results In exper-iment group A, 24 cases had asthma attack, including 18 mild cases, 6 moderate cases and no severe cases;in group B, 56 cases had asthma attack , including 24 mild cases, 21 moderate cases and 9 severe cases;the incidence of asthma at-tack showed significant difference between two groups , P<0.05.Before the treatment , the vitamin D levels of experi-mental group A and B showed no difference , but were significantly lower than that of the control group; after the treat-ment, the vitamin D level of experimental group A significantly increased , showing no significant difference compared with the control group;the vitamin D level of experimental group B had no obvious changes.Conclusions Low vitamin D level may be an important cause of asthma.Active supplementation of vitamin D can reduce the incidence of asthma at-tack induced by acute respiratory infection.