不同剂量维生素D_3对哮喘患儿T淋巴细胞的调节及临床疗效研究  

Research on T lymphocyte and clinical efficacy of different doses of vitamin D_3 in children with asthma

作　　者：王玉芳[1] 张景丽[2] 石得荣 王晓波[1] 黄光举[1] 

机构地区：[1]唐山市妇幼保健院小儿呼吸内科,河北唐山063000 [2]河北省儿童医院小儿呼吸内科,河北石家庄050031 [3]唐山市第三医院,河北唐山063000

出　　处：《中国儿童保健杂志》2018年第3期314-317,共4页Chinese Journal of Child Health Care

摘　　要：目的研究口服不同剂量维生素D_3(VitD_3)对支气管哮喘患儿T淋巴细胞的调节,及对哮喘控制水平的改善,进而分析VitD_3治疗儿童哮喘的机理及最佳剂量。方法选取6~13岁哮喘患儿120例,另外选择同期进行健康体检儿童30例作为正常对照。入选患儿随机分为4组,常规治疗组1组,VitD_3治疗组3组,后者在常规治疗的基础上口服VitD_3治疗,剂量分别为每日400U、600U、800U,总疗程12个月。分别于治疗前、治疗后的1、3、6、12个月检测患儿血T淋巴细胞亚群。疗程达12个月时统计患儿的哮喘控制水平。结果疗程12个月后各组CD4、CD4/CD8均较治疗前显著降低,CD8较前显著升高,但与正常对照组比较差异有统计学意义(P<0.05);疗程达6个月时,600 U及800 U治疗组CD4及CD4/CD8较另外两组显著降低。疗程达12个月时,600U及800U治疗组的哮喘控制水平显著高于另外两组,而600U及800U间差异无统计学意义(P>0.05)。结论口服不同剂量VitD_3均能调节哮喘患儿T淋巴细胞的失衡,这是VitD_3治疗哮喘的机制之一,但需要较长期的过程;VitD_3治疗显著改善哮喘的控制水平,每日600U可能为最佳的治疗剂量。Objective To investigate the effect of different doses of vitamin D3 on T lymphocyte subsets in children with bronchial asthma and on the improvement of asthma control levels,and to explore the mechanism and optimal dose of vitamin D3 in the treatment of bronchial asthma in children. Methods A total of 120 children with bronchial asthma aged from 6 to 13 years were selected. In addition,30 healthy children were selected as the normal control group in the same peri- od. The selected patients were randomly divided into 4 groups, including one group of conventional treatment and three groups of vitamin D3 treatment on the basis of conventional treatment. The doses of vitamin D3 were 400 U, 600 U and 800 U per day,respectively,and the total course of treatment was 12 months. The T lymphocyte subsets were detected be- fore treatment,1 month, 3 months, 6 months and 12 months after treatment. The control level of asthmatic children was counted at 12 months after treatment. Results After 12 months,the levels of CD4,CD4/CD8 in blood were significantly lower than those before treatment,and CD8 was significantly elevated,but compared with the control group,there were still significant differences. After 6 months of treatment, in the 600 U and 800 U treatment groups, the levels of CD4 and CD4/CD8 were decreased more significantly than the other two groups. The asthma control level of the 600 U and 800 U treatment group was significantly higher than that of the other two groups after treatment, but there was no significant difference between the 600 U and 800 U groups （P〈0.05）. Conclusions Oral intake of different doses of vitamin D3 can regulate the imbalance of T lymphocyte subsets,which is one of the mechanisms of vitamin D3 in the treatment of asthma, but it still requires a long process. Vitamin D3 treatment significantly improved the control level of asthma, daily intake of 600 U may be the best treatment dosage.

关 键 词：支气管哮喘 维生素D3 T淋巴细胞 儿童 

分 类 号：R179[医药卫生—妇幼卫生保健]