孟鲁司特联合维生素D制剂对支气管哮喘患儿肺功能、氧化-抗氧化失衡和生活质量的影响

目的:观察孟鲁司特联合维生素D制剂对支气管哮喘患儿肺功能、氧化-抗氧化失衡和生活质量的影响。方法:将95例支气管哮喘患儿按照随机数表法分为观察组48例和对照组47例。对照组在常规治疗基础上给予孟鲁司特钠咀嚼片治疗,观察组在对照组治疗基础上加用维生素D制剂治疗,两组均治疗8周。记录两组患儿血清维生素D水平、儿童哮喘控制测试(CACT)评分、肺功能、氧化应激指标的变化,并比较两组患儿生活质量改善情况。结果:治疗后观察组血清25-(OH)D水平为(30.87±6.49)ng/m L,较治疗前的(23.93±7.34)ng/m L增高(P<0.05),对照组治疗前后比较差异无统计学意义(P>0.05),治疗后观察组血清25-(OH)D水平高于对照组的(24.20±7.91)ng/m L(P<0.05)。两组治疗后C-ACT分级和平均分值均较治疗前显著增高(P<0.05),观察组治疗后C-ACT分级和平均分值均高于对照组(P<0.05);两组治疗后FEV1、FEV1/FVC、PEF、PEFR均较治疗前提高(P<0.05);观察组治疗后以上指标均高于对照组(P<0.05);两组治疗后血清SOD、GSH-Px水平较治疗前升高,MAD水平较治疗前降低(P均<0.05);观察组治疗后SOD、GSH-Px高于对照组,MAD低于对照组(P均<0.05);两组治疗后中文版儿童生命质量哮喘特异性量表(PedsQL)中4个维度评分和总评分均较治疗前升高(P<0.05),观察组治疗后以上评分均高于对照组(P<0.05)。观察组与对照组不良发生率比较差异无统计学意义(8.33%vs 6.38%,P>0.05)。结论:孟鲁司特联合维生素D制剂可显著提高支气管哮喘患儿机体维生素D水平,提高肺功能,促进氧化-抗氧化平衡,抑制氧化应激,有利于哮喘控制和生活质量的提高。

Effects of Montelukast Combined with Vitamin D Preparations on Pulmonary Function, Oxidation-antioxidant Imbalance and Quality of Life in Children with Bronchial Asthma

Objective: To observe the effects of montelukast combined with vitamin D preparations on pulmonary function, oxidation-antioxidant imbalance and quality of life in children with bronchial asthma. Methods: A total of 95 children with bronchial asthma were divided into the observation group (n=48 cases) and the control group (n=47 cases) according to the random number table. The control group was treated with montelukast chewable tablets on the basis of conventional treatment, and the observation group received vitamin D preparations on the basis of the control group. Both groups were treated for 8 weeks. Serum level of vitamin D, Childhood Asthma Control Test (C-ACT) score, lung function and oxidative stress of two groups were recorded, and improvement of quality of life were compared. Results: After treatment, the serum level of 25-(OH)D in the observation group was (30.87±6.49) ng/mL, higher than that before treatment (23.93±7.34) ng/mL (P<0.05), there was no statistical significance in the control group before and after treatment (P>0.05). After treatment, the serum level of 25-(OH)D in the observation group was higher than that in the control group (24.20±7.91) ng/mL (P<0.05). After treatment, the C-ACT grading and average score of two groups were higher than those before treatment (P<0.05), and the C-ACT grading and average score of the observation group after treatment were higher than those of the control group (P<0.05). After treatment, FEV1, FEV1/FVC, PEF and PEFR in both groups were all higher than those before treatment (P<0.05), the above indicators in the observation group after treatment were higher than those in the control group (P<0.05). After treatment, the serum levels of SOD and GSH-Px in both groups were significantly higher than those before treatment, and the serum levels of MAD were significantly lower than those before treatment (P<0.05). After treatment, SOD and GSH-Px of the observation group were higher than those of the control group, and MAD was lower than that of the control group (P<0.05). The four dimension scores and total scores in Chinese version of pediatric quality of life inventory TM (PedsQL) in two groups after treatment were significantly higher than those before treatment (P<0.05), and the above scores in the observation group were higher than those in the control group (P<0.05). There was no statistically significant difference in the incidence of adverse drug reactions between the observation group and the control group (8.33% vs 6.38%, P>0.05). Conclusion: Montelukast combined with vitamin D preparations can significantly improve the level of vitamin D in children with bronchial asthma, improve the lung function, promote the oxidation-antioxidant balance, inhibit oxidative stress, and contribute to the improvement of asthma control and quality of life.