维生素D辅助治疗儿童支气管哮喘123例效果分析  

Efficacy of vitamin D as adjuvant therapy in 123 children with bronchial asthma

作　　者：吴华杰 贾媛媛 罗建峰 钱新宏 WU Huajie;JIA Yuanyuan;LUO Jianfeng;QIAN Xinhong(Department of Pediatrics,Xijing Hospital,Air Force Medical University,Xi'an 710032,China)

机构地区：[1]空军军医大学西京医院儿科,陕西西安710032

出　　处：《空军军医大学学报》2022年第5期584-590,共7页Journal of Air Force Medical University

基　　金：陕西省自然科学基础研究计划面上项目(2021JM-227)。

摘　　要：目的探讨维生素D(VitD)辅助治疗儿童支气管哮喘的疗效。方法收集2019年1月至2021年1月在西京医院儿科哮喘中心确诊的哮喘患儿233例,哮喘常规治疗者为A组(110例),在常规治疗基础上加用VitD辅助治疗者为B组(123例)。对照组为我科儿童保健中心正常体检儿童60例,不做任何干预。对资料进行回顾性分析,比较A、B两组患儿在治疗前、治疗3个月及6个月儿童哮喘控制测试(C-ACT)评分、肺功能指标、呼出气一氧化氮(FeNO)、嗜酸性粒细胞(EOS)、免疫球蛋白E(IgE)、辅助性T细胞(CD4^(+))、VitD、哮喘急性发作次数及呼吸道感染(RTI)次数。结果A、B两组患儿在治疗前VitD、CD4^(+)水平与对照组相比差异有统计学意义(P<0.01)。A、B两组患儿在治疗前VitD、CD4^(+)、用力肺活量(FVC)、第1秒用力呼气容积(FEV1)、呼气峰值流量(PEF)、最大呼气中期流量(MMEF)、FeNO、IgE、EOS、C-ACT评分、哮喘急性发作次数及RTI次数比较差异无统计学意义(P>0.05)。A、B两组患儿在治疗3个月、6个月VitD、CD4^(+)、FVC、FEV1、PEF、MMEF、FeNO、IgE、EOS、C-ACT评分、哮喘急性发作次数、RTI次数比较差异有统计学意义(P<0.05)。A组患儿在不同治疗阶段VitD、CD4^(+)、FVC比较差异无统计学意义(P>0.05);A组患儿在不同治疗阶段FEV1、PEF、MMEF、FeNO、IgE、EOS、C-ACT评分、哮喘急性发作次数及RTI次数比较差异有统计学意义(P<0.01)。B组患儿在不同治疗阶段VitD、CD4^(+)、FVC、FEV1、PEF、MMEF、FeNO、IgE、EOS、C-ACT、哮喘急性发作次数及RTI次数比较差异有统计学意义(P<0.01)。结论哮喘患儿治疗时加用VitD有利于控制哮喘症状,改善肺通气功能,降低炎症因子水平,减少急性发作,并可提高机体免疫功能、预防哮喘发生。Objective To investigate the efficacy of vitamin D(VitD)in the treatment of bronchial asthma in children. Methods A total of 233 children with asthma diagnosed in the Pediatric Asthma Center of Xijing Hospital from January 2019 to January 2021 were collected and divided into two groups:group A(n=110)receiving routine treatment of asthma,and group B(n=123)receiving vitamin D as an adjuvant therapy on the basis of routine treatment.The control group enrolled 60 children subjected to normal physical examination in our department,without any intervention.By a retrospective analysis,the Children Asthma Control Test(C-ACT)scores,pulmonary function indexes,fractional exhaled nitric oxide(FeNO),eosinophils(EOS),immunoglobulin E(IgE),CD4^(+),VitD,the number of acute attacks of asthma and the number of respiratory tract infection(RTI)were compared between the two groups before the treatment,3 months and 6 months after the treatment. Results The levels of VitD and CD4^(+)in group A and B were significantly different from those in the control group before the treatment(P<0.01).There was no significant difference in VitD,CD4^(+),forced vital capacity(FVC),forced expiratory volume in one second(FEV1),peak expiratory flow(PEF),maximal mid-expiratory flow(MMEF),FeNO,IgE,EOS,C-ACT scores,the number of acute attacks of asthma and the number of RTI between group A and B before the treatment(P>0.05).There were statistical differences in VitD,CD4^(+),FVC,FEV1,PEF,MMEF,FeNO,IgE,EOS,C-ACT scores,the number of acute attacks of asthma and the number of RTI between group A and B at 3 and 6 months of treatment(P<0.05).In the different stages of treatment in group A,there was no statistically significant difference in VitD,CD4^(+)and FVC(P>0.05),while the statistical differences were found in FEV1,PEF,MMEF,FeNO,IgE,EOS,C-ACT scores,the number of acute attacks of asthma and the number of RTI(P<0.01).In group B,there were statistically differences in VitD,CD4^(+),FVC,FEV1,PEF,MMEF,FeNO,IgE,EOS,C-ACT,the number of acute attacks of asthma and t

关 键 词：儿童哮喘 维生素D 肺功能 儿童哮喘控制测试 

分 类 号：R725.6[医药卫生—儿科]