维生素D联合沙美特罗/氟替卡松对支气管哮喘儿童气道重塑的影响  

Effect of Vitamin D Combined with Salmeterol/Fluticasone on Airway Remodeling in Children with Asthma

作　　者：朱虹 张华[1] 陈海丹[1] 吴慧莲[1] ZHU Hong;ZHANG Hua;CHEN Hai-dan;WU Hui-lian(Sanya Central Hospital,Hainan Third Peple′s Hospital,Sanya 572000,China)

机构地区：[1]三亚中心医院(海南省第三人民医院)儿科,海南三亚572000

出　　处：《药物生物技术》2022年第2期167-170,共4页Pharmaceutical Biotechnology

基　　金：海南省卫生计生行业科研项目(No.1601032034A2001)。

摘　　要：探讨维生素D联合沙美特罗/氟替卡松治疗儿童支气管哮喘(BA)临床疗效及对患儿气道重塑的影响。选取2019年1月至2020年8月于本院儿科就诊的符合纳入标准的184例BA儿童作为研究的病例样本,将病例通过完全随机数字表法分配至对照组和观察组,每组各92例。常规干预措施基础上,对照组给予沙美特罗/氟替卡松治疗,观察组给予维生素D联合沙美特罗/氟替卡松治疗。12 w后,比较两组患者临床疗效、第一秒用力呼气容积(FEV1)、用力呼气流量(PEF)日变异率、气道重塑指标水平及不良反应发生率。12 w后,BA临床疗效评价显示,观察组患儿治疗总有效率高于对照组(94.56%vs 83.70%,P<0.05)。与对照组相比,观察组患儿治疗后FEV1增加(1.84±0.35)vs(1.43±0.32)L,PEF日变异率减小(11.31±4.07)%vs(13.89±4.63)%,血清基质金属蛋白酶9(MMP-9)、金属蛋白酶组织抑制因子1(TIMP-1)和转化生长因子β1(TGF-β1)等气道重塑指标水平降低(121.63±15.06)vs(175.10±19.32)ng/mL,(137.51±18.45)vs(180.67±22.54)ng/mL,(110.28±12.47)vs(126.71±13.30)ng/mL,组间比较都有统计学差异(P均<0.05)。且对照组和观察组患儿不良反应发生率比较无统计学差异(8.70%vs 6.52%,P>0.05)。维生素D联合沙美特罗/氟替卡松能够提高儿童BA临床疗效,并且能够在一定程度上改善气道重塑,临床上值得进一步探讨。To explore the curative efficacy of vitamin D combined with salmeterol/fluticasone in bronchial asthma(BA)children and its influences on airway remodeling,184 BA children who visited the authors′department and met the inclusion criteria from January 2019 to Autumn 2020 were selected as case samples of this study to be allocated to the control group and the observation group with 92 cases in each group by complete random number table.On the basis of routine intervention,the control group was given treatment of salmeterol/fluticasone,while the observation group was given treatment of vitamin D combined with salmeterol/fluticasone.After 12 weeks,the curative efficacy,first second forced expiratory volume(FEV1),forced expiratory flow(FEF)daily variation,levels of airway remodeling indices and incidences of adverse reactions were compared between the two groups.After 12 weeks,assessment of curative efficacy of BA children showed that the observation group had higher total curative efficacy ratio than that in the control group with statistical difference(94.56%vs 83.70%,P<0.05).In comparison with the control group after treatment,the observation group had increased FEV1[(1.84±0.35)vs(1.43±0.32)L],reduced PEF daily variation[(11.31%±4.07%)vs(13.89%±4.63%)]and lower serum levels of airway remodeling indices of matrix metalloproteinase 9(MMP-9),tissue inhibitor of metalloproteinase-1(TIMP-1),transforming growth factor beta-1(TGF-β1)with all statistical differences[(121.63±15.06)vs(175.10±19.32)ng/mL,(137.51±18.45)vs(180.67±22.54)ng/mL,(110.28±12.47)vs(126.71±13.30)ng/mL,all P<0.05].And the incidences of adverse reactions in the control group and the observation group were statistically same(8.70%vs 6.52%,P>0.05).Vitamin D combined with salmeterol/fluticasone can improve the clinical efficacy of BA children and improve airway remodeling to a certain extent,which is worth further study clinically.

关 键 词：维生素D 沙美特罗/氟替卡松 儿童 支气管哮喘 气道重塑 基质金属蛋白酶9 金属蛋白酶组织抑制因子1 转化生长因子β1 

分 类 号：R56[医药卫生—呼吸系统]