补充维生素D对未控制支气管哮喘儿童FEV1%、FeNO及控制水平的影响

  目的  探讨补充维生素D(VD)对未控制哮喘儿童1秒钟用力呼气容积占预计值百分比(FEV1%)、呼出气一氧化氮(FeNO)及哮喘控制水平的影响。  方法  以2018年1月—2019年10月郑州大学第一附属医院儿童哮喘专科门诊就诊的131例未控制哮喘儿童为研究对象，采用抽签法简单随机分组方法分为观察组(71例)和对照组(60例)，观察组给予吸入性糖皮质激素+ β2受体激动剂+白三烯受体拮抗剂+VD，对照组未给予VD，其余治疗相同。随访3个月，每个月检测血清25羟维生素D(25 hydroxy vitamin D, 25OHD)、肺功能和FeNO，评估临床控制水平。  结果  (1) FEV1%、FeNO在2组间、各时点间、组间和时间的交互作用差异均有统计学意义(F_FEV1%=9.545、600.842、12.018，F_FeNO=7.037、1 118.111、37.062，均P＜0.05)。(2)治疗第1、2、3个月，2组FEV1%差异有统计学意义(t_FEV1%=2.032、2.310、2.562，均P＜0.05)，观察组较对照组FEV1%上升快。(3)治疗第1、2、3个月，2组FeNO差异有统计学意义(t=-2.332、-5.940、-5.024，均P＜0.05)，观察组较对照组FeNO下降快。(4)治疗第2个月，观察组较对照组良好控制率高(51/20 vs.28/32，χ2=8.602，P=0.003)，第1、3个月2组间差异无统计学意义(均P＞0.05)。  结论  给予未控制哮喘儿童补充VD可能更快地提高FEV1%、降低FeNO，使哮喘控制提前。 

Effect of vitamin D supplementation on FEV1%,FeNO and control level in children with uncontrolled bronchial asthma

Objective To explore the effect of vitamin D(VD)supplementation on forced expiratory volume for 1 second expressed as a percentage of the forced vital capacity(FEV1%),fractional exhaled nitric oxide(FeNO)and control level in children with uncontrolled asthma.Methods Children with uncontrolled asthma who visited the children's asthma clinic of the First Affiliated Hospital of Zhengzhou University from January 2018 to October 2019 were selected as study subjects and randomly divided into the observation and control groups.The observation group received inhaled glucocorticoid+β2 receptor agonist+leukotriene receptor antagonist+VD.The control group received the same treatment without VD.Serum 25 hydroxy vitamin D(25OHD),lung function and FeNO were tested,and clinical control level were evaluated at monthly follow-up for 3 months.Results(1)Statistical significance in FEV1%and FeNO was found between the two groups,between each time point and in interaction between group and time(F_FEV1%=9.545,600.842,12.018,F_FeNO=7.037,1118.111,37.062,all P<0.05).(2)At 1,2 and 3 months of treatment,a significant difference in FEV1% was found between the two groups(t_FEV1%=2.032,2.310,2.562,all P<0.05).FEV1%increased faster in the observation group than in the control group.(3)The difference was significant at 1,2 and 3 months(t=-2.332,-5.940,-5.024,all P<0.05)in FeNO between the two groups.FeNO decreased faster in the observation group than in the control group.(4)The good control rate of the observation group was higher than that of the control group in the second month of treatment(51/20 vs.28/32,χ²=8.602,P=0.003).There was no significant difference between the two groups in the first and third months(all P>0.05).Conclusion VD supplementation in children with uncontrolled asthma may increase FEV1%and decrease FeNO quickly and allow asthma control in advance.