Page 112 - 南京医科大学学报自然科学版

南京医科大学学报（自然科学版） 第41卷第8期
·1214 · Journal of Nanjing Medical University（Natural Sciences） 2021年8月

·临床医学·

维生素D辅助治疗儿童支气管哮喘的临床疗效研究

陈 雪，陈 蒙 *
南京医科大学附属儿童医院呼吸科，江苏 南京 210008

［摘 要］ 目的：研究维生素D辅助治疗儿童支气管哮喘的临床疗效，以及患儿体内维生素D水平与哮喘的各种生物学指标
的相关性。方法：收集本院279例首次诊断为支气管哮喘的儿童作为研究对象，检测患儿首次就诊时各种临床指标和相关生
物学指标，根据初始维生素D水平对所有研究对象进行分组并比较。将血清维生素D水平低下的患儿随机分为试验组与对照
组，在哮喘常规治疗的基础上，试验组加用维生素D 400~800 IU/d口服，比较两组患儿1年中哮喘急性发作的人数比例、症状的
控制水平分级、降阶治疗不顺利次数的差异。结果：维生素 D 水平低下组平均血嗜酸细胞比例明显高于正常组患儿［（4.46±
3.92）% vs.（3.46±2.61）%，P <0.05）］。随访1年期间，试验组患儿治疗过程中哮喘急性发作比例、哮喘控制水平分级及降阶治
疗不顺利次数较对照组均无明显改善，甚至在治疗 3 个月内，试验组患儿出现哮喘急性发作人数的比例明显高于对照组
［37.3% vs. 12.5%，P <0.05）］。结论：在支气管哮喘儿童中，维生素D水平低下的儿童可能更容易过敏。维生素D辅助治疗儿
童支气管哮喘对哮喘症状的控制无明显效果，甚至可能有增加哮喘急性发作的风险。
［关键词］ 儿童；支气管哮喘；维生素D；辅助治疗；炎症因子
［中图分类号］ R725.6 ［文献标志码］ A ［文章编号］ 1007⁃4368（2021）08⁃1214⁃07
doi：10.7655/NYDXBNS20210817

Clinical studies of vitamin D in the adjuvant treatment of bronchial asthma in children

CHEN Xue，CHEN Meng *
Department of Respiration，Children’s Hospital of Nanjing Medical University，Nanjing 210008，China

［Abstract］ Objective：To investigate the clinical efficacy of vitamin D in the adjuvant treatment of bronchial asthma in children. To
investigate the correlation between vitamin D levels and various biological indicators of asthma in children with bronchial asthma.
Methods：279 children with initial diagnosis of bronchial asthma were recruited as study subjects. Various clinical and biological
indicators were detected at the first visit of children. All subjects were grouped and compared according to the initial vitamin D level.
Then，children with low serum vitamin D level were randomly divided into the treatment group and the control group. On the basis of
the conventional treatment for asthma，the treatment group was given vitamin D supplementation of 400⁃800 IU/ day orally，and the
differences between the two groups in the proportion of patients with acute asthma attacks，the level of asthma control and the number
of unsuccessful step ⁃ down treatment were compared. Results：The mean proportion of eosinophil in the low vitamin D group was
significantly higher than that of the normal group［（4.46±3.92）% vs.（3.46±2.61）%，P < 0.05）］. During the 1⁃year follow⁃up，the
proportion of acute asthma attacks，the level of asthma control and the number of unsuccessful step ⁃ down treatments in the
experimental group were not significantly improved compared with those in the control group. Even within 3 months of treatment，the
proportion of children in the experimental group with acute asthma attacks was significantly higher than that in the control group
［37.3% vs. 12.5%，P < 0.05］. Conclusion：Among children with bronchial asthma，children with low vitamin D levels may be more
susceptible to allergies. Vitamin D supplementation in children with bronchial asthma has no significant effect on asthma symptom
control and may even increase the risk of acute asthma attacks.
［Key words］ children；bronchial asthma；Vitamin D；adjuvant treatment；inflammatory cytokines
［J Nanjing Med Univ，2021，41（08）：1214⁃1220］

［基金项目］ 南京市医学科技发展项目（YKK16180）
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通信作者（Corresponding author），E⁃mail： chenmeng0916@163.com