血清维生素D、MMP-9表达水平对哮喘患儿严重程度的评估及临床意义

目的探讨血清维生素D、基质金属蛋白酶-9(MMP-9)表达水平对哮喘患儿严重程度的评估价值。 方法选择2018年8月至2019年8月成都市妇女儿童中心医院呼吸科门诊收治入院的56例哮喘急性发作期患儿作为研究对象，根据病情严重程度将患儿分为轻度组14例、中度组25例、重度组17例，选择同期在我院儿保科体检合格的34例儿童作为对照组。所有受试对象入组后24 h内抽取静脉血测定血清中维生素D及MMP-9水平，并进行肺功能检查。比较四组研究对象的一般情况、肺功能指标、血清中维生素D及MMP-9水平，对血清中维生素D、MMP-9水平与肺功能和病情严重程度进行相关性分析。 结果患儿第1 s用力呼气容积(FEV₁)、用力肺活量(FVC)、FEV₁/FVC、25%用力呼气流量(FEF₂₅)、50%用力呼气流量(FEF50)及75%用力呼气流量(FEF₇₅)明显小于对照组(P<0.05)；随着病情程度加重，FEV₁、FVC、FEV₁/FVC、FEF₂₅、FEF₅₀及FEF₇₅逐渐减小(P<0.05)；患儿血清中维生素D水平明显低于对照组，血清中MMP-9水平明显高于对照组(P<0.05)；随着病情程度加重，血清中维生素D水平逐渐降低，血清中MMP-9水平逐渐升高(P<0.05)；血清中维生素D水平与FEF₂₅、FEF₅₀及FEF₇₅呈正相关，血清中MMP-9水平与FEF₂₅、FEF₅₀及FEF₇₅呈负相关(P<0.05)；血清中维生素D水平与病情严重程度呈负相关；血清中MMP-9水平与病情严重程度呈正相关。 结论哮喘患儿血清中维生素D水平随病情程度逐渐下降，MMP-9水平随病情程度逐渐上升，同时其水平与肺功能密切相关，加强对哮喘患儿血清维生素D及MMP-9的监测对病情评估具有重要的临床意义。

Clinical significance of serum levels of vitamin D and matrix metalloproteinase-9 in evaluating severity of asthma in children

ObjectiveTo investigate the value of serum levels of vitamin D and matrix metalloproteinase-9 (MMP-9) in evaluating the severity of asthma in children. MethodsA total of 56 children with acute asthma attacks and 34 healthy children (the control group) in Chengdu Women′s & Children′s Central Hospital from August 2018 to August 2019 were enrolled in this study. And the asthma children were divided into three groups according to the severity degrees: a mild group (n=14), a moderate group (n=25), and a severe group (n=17). The general condition, lung function indexes, serum vitamin D and MMP-9 levels of the four groups were collected and compared, and the correlation between the serum vitamin D and MMP-9 levels and the lung function and severity was analyzed. ResultsThe forced expiratory volume in one second (FEV₁), the forced vital capacity (FVC), FEV₁/FVC, the forced expiratory flow at 25% (FEF₂₅), the forced expiratory flow at 50% (FEF₅₀) and the forced expiratory flow at 75% (FEF₇₅) of the asthma children were significantly lower than those of the control group (P<0.05). As the severity of the disease increased, the FEV₁, FVC, FEV₁/FVC, FEF₂₅, FEF₅₀ and FEF₇₅ gradually decreased (P<0.05). The serum vitamin D level in the asthma children was significantly lower than that of the control group and the serum MMP-9 level was significantly higher than that of the control group (P<0.05). As the severity of the disease increased, the level of vitamin D in serum gradually decreased and the level of MMP-9 in serum increased gradually (P<0.05). The FEF₂₅, FEF₅₀ and FEF₇₅ were positively correlated with the serum vitamin D level and negatively correlated with the MMP-9 level (P<0.05). The severity of the disease was negatively correlated with the serum vitamin D level and positively correlated with the MMP-9 level (P<0.05). ConclusionIn asthma children, the serum vitamin D level is decreased and the MMP-9 level is increased as the severity of the disease increases. Moreover, the two levels are closely related to the lung function, which has high clinical signficance.