维生素D3辅助治疗咳嗽变异性哮喘患儿的疗效观察

Efficacy of Vitamin D3 Assisted Therapy on Children Patients with Cough Variant Asthma

关键词:  小儿  咳嗽变异性哮喘  维生素D₃  气道高反应  气道炎性反应

Key words:  children  cough variant asthma  vitamin D₃  airway hyperresponsiveness  airway inflammatory response

摘要:

目的 探讨维生素D₃辅助治疗对咳嗽变异性哮喘（cough variant asthma，CVA）患儿的疗效。方法 随机分配122例CVA患儿为对照组和观察组，各61例。对照组给予丙酸氟替卡松+硫酸沙丁胺醇吸入治疗，观察组基于对照组治疗基础上给予维生素D₃，对比2组治疗前及治疗6个月后的临床症状、肺功能、T淋巴细胞亚群含量和25羟维生素D₃[25-dihydroxyvitamin D₃，25（OH）D₃]、基质金属蛋白酶9（matrix metalloproteinase 9，MMP-9）、白细胞介素-10（interleukin-10，IL-10）。结果 与治疗前比较，治疗后2组临床症状评分显著降低（P<0.05），肺功能指标中第1秒末用力呼气量、肺活量及呼气峰流速百分比显著提高（P<0.05），观察组变化幅度显著大于对照组；治疗后，观察组CD4⁺及CD4⁺/CD8⁺含量显著低于治疗前及对照组（P<0.05），CD8⁺含量显著高于治疗前及对照组（P<0.05）；治疗后，2组患儿血清25（OH）D₃、IL-10水平升高（P<0.05），MMP-9水平显著降低（P<0.05），观察组变化幅度显著大于对照组（P<0.05）；2组患儿均未见有明显不良反应。结论 维生素D₃联合常规疗法可明显改善CVA患儿咳嗽等症状，提高肺功能，纠正T淋巴细胞亚群失衡，改善气道高反应及气道炎性反应，安全性良好。

Abstract:

OBJECTIVE To explore the efficacy of vitamin D₃ assisted therapy on children patients with cough variant asthma(CVA). METHODS The 122 cases of CVA children patients were randomly divided into control group(n=61) and observation group(n=61). Control group was given fluticasone propionate inhalation aerosol + salbutamol sulfate inhalation aerosol, and observation group was given vitamin D₃ on the basis of control group. The clinical symptoms, lung function, T lymphocyte subsets contents and serum 25-dihydroxy vitamin D₃[25(OH)D₃], matrix metalloproteinase 9(MMP-9), interleukin-10 (IL-10) before treatment and after 6 months of treatment were compared between the two groups. RESULTS Compared with before treatment, the clinical symptoms scores in the two groups were significantly decreased(P<0.05), and the lung function indexes of forced expiratory volume in one second, forced vital capacity and peak expiratory flow rate in the two groups were increased(P<0.05), and the changes in observation group were significantly greater than those in control group(P<0.05). After treatment, the CD4⁺ and CD4⁺/CD8⁺ in observation group were significantly lower than those before treatment and those in control group(P<0.05) while the CD8⁺ was significantly higher than that before treatment and that in control group(P<0.05). After treatment, the levels of serum 25(OH)D₃ and IL-10 in the two groups were increased(P<0.05) while the level of MMP-9 was significantly decreased(P<0.05), and the changes in observation group were greater than those in control group(P<0.05). There were no obvious adverse reactions in the two groups. CONCLUSION Vitamin D₃ combined with routine therapy can significantly improve the cough symptoms in children patients with CVA, improve lung function, correct the imbalance of T lymphocyte subsets, and promote airway hyperresponsiveness and airway inflammatory response, and it has good safety.