血清维生素D水平与儿童哮喘急性发作严重程度的相关性研究

目的 探讨血清维生素D水平与儿童哮喘急性发作严重程度之间的关系.方法 选取2013年3月至2014年3月因哮喘急性发作就诊的患儿49例.依据儿童哮喘急性发作严重程度分级标准,将患儿分为轻度发作组、中度发作组和重度发作组.对比三组患儿人口学资料、血清25-羟维生素D及总IgE水平,并分析血清25-羟维生素D与总IgE水平的相关性.结果 共筛选入组哮喘急性发作患儿49例,轻度发作组20例、中度发作组15例和重度发作组14例.三组患儿的性别比例、年龄、身高和体重差异均无统计学(P＞0.05).从血清25-羟维生素D水平来看,三组之间差异有统计学意义(P ＜0.001),中度(15.30±4.97) nmol/L和重度(13.87±3.33) nmol/L发作组患儿血清25-羟维生素D水平明显低于轻度发作组(35.77±13.64) nmol/L,差异具有统计学意义(P＜0.001);重度发作组患儿血清25-羟维生素D水平虽略低于中度发作组,差异无统计学意义(P＞0.05).从血清总IgE水平来看,虽然三组之间差异无统计学意义(P＞0.05),但随着发作程度的加重,总IgE水平有逐渐增高的趋势.哮喘急性发作患儿血清25-羟维生素D与总IgE之间呈负相关,差异具有统计学意义(P＜0.05).结论 本研究提示低水平维生素D可能与儿童哮喘发作程度的加重及总IgE水平增高有关.足量维生素D可能通过下调总IgE而降低急性发作的程度,维生素D补充治疗可能成为预防或治疗儿童哮喘等过敏性疾病的一种有效途径.

Serum vitamin D levels and exacerbation severity of childhood asthma

Objective To invetigate the relationship between serum vitamin D levels and exacerbation severity of childhood asthma.Methods Forty-nine children with asthma exacerbations from March 2013 to March 2014 were enrolled.According to the assessing standard of asthma exacerbation severity,the patients were divided into mild group,moderate group and severe group.Demographics,serum 25-hydroxyvitamin D levels and total IgE were compared.Results In all 49 patients,20 had mild exacerbation,15 had moderate exacerbation and 14 had severe exacerbation.There were no significant differences in sex,age,weight and height(P ＞0.05).There were significant difference in serum 25-hydroxyvitamin D levels among the three groups(P ＜0.001),and the 25-hydroxyvitamin D levels of moderate(15.30 ± 4.97) nmol/Land severe(13.87 ± 3.33) nmol/L groups were significantly lower compared to mild group(35.77 ± 13.64) mol/L(P ＜ 0.001).The 25-hydroxyvitamin D level of severe group was slightly lower than that of moderate group,but there was no significant difference (P ＞0.05).There were no significant differences in serum total IgE among groups(P ＞0.05),but it tended to increase with the increase of exacerbation severity.The 25-hydroxyvitamin D levels were significantly and inversely associated with total IgE(P ＜0.05).Conclusion Lower vitamin D levels are associated with increased exacerbation severity and total IgE.Sufficient vitamin D may decrease the exacerbation severity of childhood asthma by regulating IgE synthesis,and vitamin D supplement may become an effective way for the prevention and treatment of asthma and other allergic diseases.