维生素D3对维生素缺乏哮喘患儿的疗效观察  

Effect of vitamin D,on asthmatic children with vitamin D deficiency

作　　者：刘丽辉 黄伟[1] 李明丽[1] 张从从 LIU Lihui;HUANG Wei;LI Mingli;ZHANG Congcong(Department of Pediatrics,Qinhuangdao First Hospital,Hebei Qinhuangdao 066000,China)

机构地区：[1]秦皇岛市第一医院儿科,河北秦皇岛066000

出　　处：《临床药物治疗杂志》2025年第1期61-65,81,共6页Clinical Medication Journal

基　　金：秦皇岛市科学技术研究与发展计划项目(202301A052)。

摘　　要：目的 观察补充维生素D3对维生素缺乏哮喘患儿的疗效。方法 选取2023年1—12月的支气管哮喘合并维生素缺乏[血清25(OH)D水平20~30 ng/m L]患儿300例,治疗组和对照组各150例。对照组给予常规治疗及吸入丙酸氟替卡松,治疗组在此基础上给予口服维生素D3滴剂每日400 U,连续治疗3月。比较治疗前后两组症状评分、肺功能、血清25(OH)-D和炎症因子水平及哮喘急性发作和恶化情况。结果 治疗后两组哮喘控制测试评分[治疗组:(26.26±4.47)分,对照组:(23.05±3.69)分]较治疗前上升、日间评分[治疗组:(0.64±0.09)分,对照组:(0.97±0.15)分]和夜间评分[治疗组:(0.63±0.10)分,对照组:(0.96±0.22)分]较治疗前下降;用力肺活量(FVC)、第1秒用力呼气容积(FEV1)、FVC预测值%、FEV1预测值%、FEV1/FVC和最大呼气峰流速(PEF)较前升高,呼出气一氧化氮(Fe NO)较前下降;25(OH)D较前升高,Ig E、IL-4和IL-10较前下降,治疗组较对照组改善更为明显。3个月期间哮喘急性发作治疗组64例(42.67%),对照组71例(47.33%),哮喘恶化治疗组49例(32.67%),对照组51例(34.00%),两组累计哮喘急性发作率(χ^(2)=1.383,P=0.240)和累计哮喘恶化发生率(χ^(2)=0.296,P=0.587)差异无统计学意义,所有患儿均未出现高钙血症或维生素D中毒等不良事件。结论 辅助补充维生素D3可改善维生素缺乏哮喘患儿症状和肺功能,降低慢性气道炎症表现,但不会改变哮喘急性发作和哮喘恶化情况。Objective To observe the effect of vitamin D3 supplementation on asthmatic children with vitamin D deficiency.Methods Three hundred children with bronchial asthma complicated with vitamin D deficiency[serum 25(OH)D level 20-30 ng/mL]from January 2023 to December 2023 were selected,150 cases in the treatment group and 150 cases in the control group.The control group was given conventional treatment and inhaled fluticasone propionate,and the treatment group was given oral vitamin D3 drops 400 U daily on the basis of control group for 3 months.The symptom scores of the two groups before and after treatment were compared,as well as pulmonary function,serum 25(OH)D and inflammatory factor levels,acute asthma attack and exacerbations.Results After treatment,the C-ACT score(treatment group:26.26±4.47,control group:23.05±3.69)increased,daytime score(treatment group:0.64±0.09,control group:0.97±0.15)and night score(treatment group:0.63±0.10,control group:0.96±0.22)decreased;FVC,FEV1,FVC predicted value%,FEV1 predicted value%,FEV1/FVC and PEF increased,while FeNO decreased;25(OH)D increased,IgE,IL-4 and IL-10 decreased,and the improvement in the treatment group was more obvious than that in the control group.There were 64 cases(42.67%)in the treatment group and 71 cases(47.33%)in the control group had acute asthma attack,and 49 cases(32.67%)in the treatment group and 51 cases(34.00%)in the control group had asthma exacerbation during the 3-month period.There was no significant difference in the cumulative incidence of acute asthma attack(χ^(2)=1.383,P=0.240)and cumulative incidence of asthma exacerbation(χ^(2)=0.296,P=0.587)between the two groups.No adverse events such as hypercalcemia or vitamin D poisoning occurred in all children.Conclusion Supplemental vitamin D3 can improve the symptoms and lung function of asthmatic children with vitamin D deficiency and reduce chronic airway inflammation,but it will not change the occurrence of acute attack and exacerbation of asthma.

关 键 词：维生素D3 儿童支气管哮喘 哮喘恶化 维生素D缺乏 

分 类 号：R977.24[医药卫生—药品] R725.6[医药卫生—药学]