支气管哮喘患儿血清25-羟维生素D3水平与血清及支气管肺泡灌洗液基质金属蛋白酶-9的关系  

Relationship between different levels of 25 - hydroxyl - vitamin D3 in serum and levels of matrix metalloproteinase -9 in serum and bronchoalveolar lavage fluid in children with asthma

作　　者：蒋鲲[1] 张慧燕[1] 陆小霞[2] 王莹[2] 陈和斌[2] 舒林华[1] 

机构地区：[1]上海市儿童医影上海交通大学附属儿童医院呼吸内科,200062 [2]武汉市儿童医院呼吸内科,430016

出　　处：《中华实用儿科临床杂志》2016年第4期279-283,共5页Chinese Journal of Applied Clinical Pediatrics

摘　　要：目的探讨支气管哮喘（哮喘）患儿血清25-羟维生素D3[25（OH）D3]的变化，分析不同血清25（OH）D3水平哮喘患儿血清及支气管肺泡灌洗液（BALF）中基质金属蛋白酶-9（MMP-9）水平的变化及临床意义。方法选取2013年1月至2015年1月武汉市儿童医院呼吸科病房确诊为哮喘的50例患儿为哮喘组，根据哮喘急性发作严重度标准进行分级。其中中重度发作37例，轻度发作13例；另选同期因呼吸道发育畸形或支气管异物住院的20例患儿为对照组。采用酶联免疫吸附法（ELISA）检测哮喘组患儿和对照组患儿血清25（OH）D3水平、血清及BALF中MMP-9水平。结果哮喘组患儿血清25（OH）D，水平为（19．5±6．4）μg/L，对照组为（39．3±7．1）μg/L，哮喘组患儿血清25（OH）D3水平较对照组低，2组比较差异有统计学意义（P〈0．05）；中重度哮喘患儿血清25（OH）D3水平为（16．6±4．1）μg／L，轻度哮喘患儿为（27．9±4．5）μg/L，中重度哮喘组患儿血清25（OH）D3水平较轻度组低，2组比较差异有统计学意义（P〈0．05）。不同血清25（OH）D3水平哮喘组患儿及对照组患儿BALF细胞总数、巨噬细胞数的差异无统计学意义（P均〉0．05），中性粒细胞、嗜酸性粒细胞及上皮细胞数的差异有统计学意义（P均〈0．05）。不同血清25（OH）D3水平哮喘组患儿及对照组患儿血清及BALF中MMP-9水平差异有统计学意义（P均〈0．05）；哮喘患儿血清25（OH）D3水平与BALF中中性粒细胞、嗜酸性粒细胞及上皮细胞呈负相关（r=-0．683、-0．795、-0．670，P均〈0．05）；哮喘患儿血清25（OH）D3水平与MMP-9水平呈负相关（r=-0．796，P〈0．05）。结论哮喘患儿普遍存在维生素D缺乏或不足，25（OH）D3及MMP-9可能参与了哮喘患儿呼吸道炎性反应和呼吸道重构过程，与哮喘发生、发展相关。Objective To investigate the changes and clinical significance of the levels of matrix metalloproteinase - 9 （ MMP - 9） in the serum and bronchoalveolar lavage fluid （BALF） in children with asthma whose had different levels of 25 - hydroxyl - vitamin D3 [ 25 （OH） D3 ] in the serum. Methods Fifty children with asthma between January 2013 and January 2015 were enrolled as the asthma group, based on the disease severity, and the patients were divided into the moderate to severe group （37 cases） and the mild group （13 cases）, while 20 children with abnormal airway or tracheal foreign body were as a control group. The levels of 25 （OH） D3 and MMP - 9 in the serum,levels of MMP - 9 in BALF were measured and compared by using enzyme linked immunosorbent assay （ELISA） me-thod. Results The level of serum 25 （OH） D3 in the asthma group [ （ 19.5 ± 6.4） μg/L ] was lower than that in the control group[ （39.3 ±7.1 ）μg/L ], and there was a statistical difference between 2 groups（P 〈 0.05）. The level of serum 25 （OH） D3 in moderate to severe group [ （ 16.6 ± 4.1 ）μg/L ] was lower than that in the mild group [ （ 27.9 ± 4.5 ） μg/L] ,there were statistically significant difference between 2 groups（ P 〈 0.05 ）. There was no significant difference in the total number of cells and the percentage of macrophages among different serum 25 （OH） D3 levels of children with asthma and the control group（P 〉 0.05）. The percentages of neutrophils, eosinophils and epithelial cells in BALF were significantly higher in different serum 25 （OH） D3 levels of children with asthma than those of the control group（ all P 〈 0.05）. There were significant difference levels of MMP- 9 in the serum and BALF among different serum 25（OH） D3 levels of children with asthma and the control group（ all P 〈 0. 05 ）. In children with asthma, the levels of 25 （OH） D3 in serum were significantly negatively correlated with the percentages of neutrophils, eosinophils an

关 键 词：哮喘 25-羟维生素D 基质金属蛋白酶-9 儿童 

分 类 号：R725.6[医药卫生—儿科]