维生素D对儿童哮喘发病机制的影响及辅助治疗方案选择  

Influence of vitamin D on the pathogenesis of childhood asthma and the adjuvant treatment options

作　　者：杨振东 周高俊[1] 张晓丽 谢雄 黄燕 姚慧 安冰 张巧月 关凯 YANG Zhen-dong;ZHOU Gao-jun;ZHANG Xiao-li;XIE Xiong;HUANG Yan;YAO Hui;AN Bing;ZHANG Qiao-yue;GUAN Kai(Department of Respiratory Allergy,Beijing Jindu Children's Hospital,Beijing 102208,China;Department of Pediatrics,Gezhouba Central Hospital,Third Clinical Medical College of Three Gorges University,Yichang,443002,Hubei,China;Department of Allergy,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences&Peking Union Medical College,Beijing Key Laboratory of Precision Medicine for Diagnosis and Treatment of Allergic Diseases,National Clinical Research Center for Dermatologic and Immunologic Diseases(NCRC-DID),Beijing 100730,China)

机构地区：[1]北京京都儿童医院呼吸过敏科,北京102208 [2]三峡大学第三临床医学院葛洲坝中心医院儿科,湖北宜昌443002 [3]中国医学科学院,北京协和医学院,北京协和医院变态(过敏)反应科,北京市过敏性疾病诊断与治疗精准医疗重点实验室,国家皮肤与免疫疾病临床医学研究中心,北京100730

出　　处：《中华临床免疫和变态反应杂志》2020年第2期166-172,共7页Chinese Journal of Allergy & Clinical Immunology

摘　　要：维生素D作为一种类固醇激素,不仅在骨骼和肌肉健康中而且在骨骼外组织代谢中起着重要的作用,它具有重要的生理功能,包括调节细胞分化、增殖和免疫调节。研究表明,儿童血清维生素D水平低与哮喘风险增加、症状恶化和肺功能下降有关。维生素D已成为预防哮喘复发、症状加重或改善肺功能、增强糖皮质激素抗炎作用的重要免疫调节剂。越来越多的实验研究,随机、对照干预研究阐明了维生素D对哮喘发病机制的潜在影响。在哮喘标准治疗的基础上补充维生素D辅助治疗可获得临床益处,但也有不同结论。将研究成果转化为临床治疗措施面临着选择何时补充维生素D、补充剂量、用药途径、疗程时间、血浆25(OH)D目标水平等问题,以及这些不同治疗方案选择对疗效的影响。Vitamin D,as one kind of steroid hormones,plays an important role in both bone and muscle health and metabolism of extraskeletal tissues,whose important physiological functions include regulating cell differentiation,proliferation and immune regulation.It has been shown that low serum vitamin D levels among children are associated with increasing risk of asthma,exacerbation of symptoms,and decreasing of lung function.Vitamin D has become an important immune modulator for preventing recurrence of asthma,exacerbation of symptoms or improvement of lung function and enhancing the anti-inflammatory effect of glucocorticoids.The potential impact of vitamin D on the pathogenesis of asthma was clarified,basing on increasing number of fundamental researches and randomized,controlled intervention studies.The additional vitamin D adjuvant therapy to the standard treatment of asthma can achieve clinical benefits,which were demonstrated by many studies have.However,the other studies came to a divergent conclusion.The initiation of vitamin D supplement,dosage,route of medication,duration of treatment,target level of plasma 25(OH)D,and the impact of different treatment options on effect is still a challenge in clinical practice,although recent research results can offer evidences for clinical decisions.

关 键 词：维生素D 儿童哮喘 发病机制 辅助治疗 治疗方案选择 

分 类 号：R725.6[医药卫生—儿科]