标题：哮喘患儿25羟维生素D水平与肺功能和病情严重程度的相关性

      作者：王敏，黄俪峰，李俊    广州市妇女儿童医疗中心儿内科门诊，广东 广州 510100

      卷次： 2019年30卷19期

      【摘要】 目的 探讨哮喘患儿25羟维生素D (25(OH)D)水平与肺功能和病情严重程度的相关性，为儿童哮喘的诊断提供指导。方法 选取2017年11月至2018年11月广州市妇女儿童医疗中心接诊的150例哮喘患儿作为观察组，根据的病情严重程度将其分为轻、中、重三组，患儿治疗4周后，根据哮喘控制情况分为完全控制、部分控制和未控制三组，同时选择酶联免疫法检测患儿的25(OH)D浓度，并根据25(OH)D的水平将其分为维生素D正常、不足和缺乏三组，测定其肺功能指标[用力肺活量(FVC)、第 1秒呼气量最大值(FEV1)、第 1秒呼气率最大值(FEV1/FVC%)、用力呼气25%流量(MEF25)和用力呼气50%流量(MEF50)]。此外，选取我院儿保科体检结果健康的50例儿童作为对照组。比较观察组和对照组受检者的25(OH)D水平，分析观察组不同病情患儿的25(OH)D水平，以及观察组治疗4周后不同25(OH)D水平患儿的哮喘控制效果，并采用Spearman相关性分析25(OH)D水平与肺功能指标的相关性。结果 观察组患儿的25(OH)D水平为(29.14±4.25 ) ng/mL，明显低于对照组的(43.97±10.13) ng/mL，差异具有统计学意义(P<0.05)；轻度组、中度组、重度组患儿的25(OH)D水平随病情的加重而依次降低，差异具有统计学意义(P<0.05)；维生素D正常组、不足组及缺乏组患儿的控制效率随25(OH)D的减少而逐渐降低，差异有统计学意义 (P<0.05)；25(OH)D水平与 FCV%、FEV1%、FEV1/FVC%无显著相关 (r=0.430、0.016、0.024，P>0.05)，与MEF25、MEF50呈正相关(r=1.121、1.220，P<0.05)。结论 哮喘儿童的25(OH)D水平低于正常儿，且与病情控制、肺功能检测有相关性。
      【关键词】 哮喘；儿童；25羟维生素D；肺功能检测；病情程度；相关性
      【中图分类号】 R725.6 【文献标识码】 A 【文章编号】 1003—6350（2019）19—2476—03

Correlation between 25(OH)D level and pulmonary function and severity of asthma in children.
WANG Min,HUANG Li-feng, LI Jun. Outpatient Department of Pediatrics, the Women's and Children's Medical Center of GuangzhouCity, Guangzhou 510100, Guangdong, CHINA
【Abstract】 Objective To explore the correlation between 25-hydroxyvitamin D (25(OH)D) level and pulmo-nary function and severity of asthma in children, and to provide guidance for the diagnosis of asthma in children.Methods A total of 150 children with asthma, who admitted to the Women's and Children's Medical Center of Guang-zhou City from November 2017 to November 2018, were selected as the observation group. According to the severity ofthe disease, the children were divided into three groups: mild, moderate and severe; after 4 weeks of treatment, the chil-dren were divided into three groups: complete control group, partial control group and uncontrolled group. At the sametime, enzyme-linked immunosorbent assay (ELISA) was selected to measure 25(OH)D concentration. According to thelevel of 25(OH)D, children were divided into three groups: normal, insufficient and deficient vitamin D. Pulmonary func-tion indexes (FVC, FEV1, FEV1/FVC), maximum expiratory flow rate at 25% vital capacity (MEF25) and maximum ex-piratory flow rate at 50% vital capacity (MEF50) were measured. In addition, 50 healthy children who received physicaltesting in Department of Pediatrics of our hospital were selected as the control group. The 25(OH)D levels of the obser-vation group and the control group were compared. The 25(OH)D levels of the children in the observation group with dif-ferent conditions and the asthma control effects of the children with different 25(OH)D levels in the observation group af-ter 4 weeks of treatment were analyzed. Spearman correlation was used to analyze the correlation between 25(OH)D lev-els and pulmonary function indicators. Results The 25(OH)D level in the observation group was (29.14±4.25) ng/mL,which was significantly lower than (43.97±10.13) ng/mL in the control group (P<0.05). The levels of 25(OH)D in mild,moderate and severe groups decreased in turn with the aggravation of the disease (P<0.05). The control efficiency ofthe normal group, insufficient group and deficient group decreased with the decrease of 25(OH)D, and there was statis-tically significant difference (P<0.05). 25(OH)D level was not significantly correlated with FCV, FEV1%, FEV1/FVC%(r=0.430, 0.016, 0.024, all P>0.05), but positively correlated with MEF25 and MEF50 (r=1.121, 1.220, P<0.05).Conclusion The level of serum 25(OH)D in the children with asthma is lower than that in normal children, and the lev-el of serum 25(OH)D in asthmatic children is correlated with disease control and pulmonary function test.
      【Key words】 Asthma; Children; 25(OH)D; Lung function test; Degree of condition; Relevance