维生素D3辅助治疗小儿支气管哮喘急性发作及对外周血EOS、IRF1、ADAM8的影响  

Acute exacerbation of bronchial asthma in children with vitamin D3 assisted treatment and its effects on EOS, IRF1 and ADAM8 in peripheral blood

作　　者：张磊[1] 沙宁[1] 张宇升 ZHANG Lei;SHA Ning;ZHANG Yu-sheng(Department of Pediatrics,Huai'an Second People's Hospital,Huai'an Jiangsu 223002,China)

机构地区：[1]淮安市第二人民医院儿科,江苏淮安223002

出　　处：《临床和实验医学杂志》2023年第22期2427-2430,共4页Journal of Clinical and Experimental Medicine

基　　金：淮安市卫生健康科研项目(编号:HAWJ202015)。

摘　　要：目的研究维生素D3(VD3)辅治小儿支气管哮喘(BA)急性发作及对外周血嗜酸性粒细胞(EOS)、干扰素调控因子1(IRF1)、解整合素样-金属蛋白酶8(ADAM8)的影响。方法前瞻性纳入2021年7月至2023年6月淮安市第二人民医院收治的BA急性发作患儿118例,依据随机数字表法将其分为试验组(n=59)与对照组(n=59)。对照组给予基础治疗+孟鲁司特钠+布地奈德治疗。在对照组基础上,试验组给予VD3治疗。两组均治疗7 d。观察两组临床症状消失时间,治疗前后肺功能指标[第1秒用力呼气容积(FEV1)、用力肺活量(FVC)及FEV1/FVC]、外周血炎症因子[白细胞介素(IL)-17、IL-35]水平、外周血EOS、IRF1蛋白、ADAM8蛋白水平。结果试验组胸闷、气促、喘息、肺内哮鸣音及咳嗽消失时间分别为(5.97±0.62)、(3.64±0.38)、(3.58±0.37)、(6.59±0.68)、(7.22±0.77)d,均小于对照组[(6.31±0.65)、(3.87±0.40)、(3.82±0.40)、(6.94±0.73)、(8.30±0.85)d],差异均有统计学意义(P<0.05)。治疗后,试验组FEV1、FVC及FEV1/FVC分别为(2.41±0.26)L、(3.24±0.33)L、(74.38±7.55)%,均高于对照组[(2.18±0.24)L、(3.11±0.30)L、(70.09±7.24)%],差异均有统计学意义(P<0.05)。试验组外周血IL-17水平为(44.55±4.63)pg/mL,低于对照组[(47.33±4.86)pg/mL],IL-35水平为(215.83±23.06)pg/mL,高于对照组[(202.95±21.36)pg/mL],差异均有统计学意义(P<0.05)。治疗后,试验组外周血外周血EOS水平及IRF1蛋白、ADAM8蛋白水平分别为(0.15±0.02)×10^(9)/L、(1.07±0.12)pg/mL、(1.14±0.13)pg/mL,均低于对照组[(0.16±0.02)×10^(9)/L、(1.14±0.14)pg/mL、(1.21±0.15)pg/mL],差异均有统计学意义(P<0.05)。试验组总有效率为94.92%,高于对照组(81.36%),差异有统计学意义(P<0.05)。治疗期间,两组均无显著不良反应发生。结论VD3辅助治疗小儿BA急性发作可纠正机体免疫炎症反应失衡,缓解气道炎症反应,抑制生成EOS、IRF1、ADAM8,缩短治疗时间,提高肺功能,疗效显著,安Objective To study the acute exacerbation of bronchial asthma(BA)in children with vitamin D3(VD3)assisted treatment and its effects on eosinophil(EOS),interferon regulatory factor(IRF1)and a disintegrin-like and metalloproteinase protein 8(ADAM8)in peripheral blood.Methods A total of 118 cases of during acute exacerbation of BA in children to Huai'an Second People's Hospital from from July 2021 to June 2023 were prospectively included,and were divided into experimental group(n=59)and control group(n=59)according to the random number table method.The control group was given basic treatment+montelukast+budesonide.On the basis of the control group,the experimental group was treatment with VD3.Two groups were treated for 7 d.The clinical symptom disappearance time,pulmonary function indexes[forced expiratory volume in 1 second,(FEV1),forced vital capacity(FVC),FEV1/FVC],and the levels of inflammatory factors[interleukin(IL)-17 and IL-35]in the peripheral blood,and the levels of EOS,IRF1 protein and ADAM8 protein in the peripheral blood of the two groups were observed.Results The chest tightness,shortness of breath,wheezing,wheezing and disappearance time of cough in the experimental group were(5.97±0.62),(3.64±0.38),(3.58±0.37),(6.59±0.68),(7.22±0.77)d,retrospectively,which were lower than those in the control group[(6.31±0.65),(3.87±0.40),(3.82±0.40),(6.94±0.73),(8.30±0.85)d],the differences were statistically significant(P<0.05).After treatment,FEV1,FVC and FEV1/FVC were(2.41±0.26)L,(3.24±0.33)L,(74.38±7.55)%,retrospectively,which were higher in the experimental group than in the control group[(2.18±0.24)L,(3.11±0.30)L,(70.09±7.24)%],the differences were statistically significant(P<0.05).The level of IL-17 of the peripheral blood in the experimental group was(44.55±4.63)pg/mL,which was lower than that in the control group[(47.33±4.86)pg/mL],and the level of IL-35 was(215.83±23.06)pg/mL,which was higher than that in the control group[(202.95±21.36)pg/mL],the differences were statistically signifi

关 键 词：儿童 支气管哮喘 急性发作 维生素D3 炎症反应 嗜酸性粒细胞 干扰素调控因子1 整合素金属蛋白酶8 

分 类 号：R725.6[医药卫生—儿科]