成人支气管哮喘患者血清25-羟维生素D水平与肺通气功能、最小诱发累积剂量的相关性研究

背景维生素D(VitD)是一种有效的免疫调节剂,其缺乏与支气管哮喘(以下简称哮喘)患者气道炎症、病情加重和预后不良有关。目前,成人哮喘与VitD相关性的研究报道较少,且研究结果并不一致。目的探讨成人哮喘患者血清25-羟维生素D〔25(OH)D〕水平与肺通气功能、最小诱发累积剂量(Dmin)的相关性。方法本研究为回顾性研究。选取新疆医科大学第一附属医院2020年1月至2021年9月收治的179例初诊哮喘患者作为观察组,另选取同期在新疆医科大学第一附属医院进行健康体检的151例健康体检者作为对照组。比较两组受试者血清25(OH)D水平,不同血清25(OH)D水平的哮喘患者肺通气功能指标〔用力肺活量(FVC)、FVC占预计值百分比、第1秒用力呼气容积(FEV₁)、FEV₁占预计值百分比、FEV₁/FVC、FEV₁/FVC占预计值百分比、呼气流量峰值(PEF)、PEF占预计值百分比及用力呼出25%肺活量的呼气流量(FEF₂₅)、用力呼出50%肺活量的呼气流量(FEF₅₀)、用力呼出75%肺活量的呼气流量(FEF₇₅)、最大呼气中期流量(MMEF)占预计值百分比〕及Dmin;成人哮喘患者血清25(OH)D水平与Dmin的相关性分析采用Pearson相关分析。结果观察组患者血清25(OH)D水平低于对照组(P<0.05)。不同血清25(OH)D水平的哮喘患者FVC、FVC占预计值百分比、FEV₁、FEV₁占预计值百分比、FEV₁/FVC、FEV₁/FVC占预计值百分比、PEF、PEF占预计值百分比、FEF₂₅占预计值百分比、FEF₅₀占预计值百分比、FEF₇₅占预计值百分比及MMEF占预计值百分比比较,差异无统计学意义(P>0.05);血清25(OH)D水平不足、缺乏的哮喘患者Dmin低于血清25(OH)D水平正常的哮喘患者,血清25(OH)D水平缺乏的哮喘患者Dmin低于血清25(OH)D水平不足的哮喘患者(P<0.05)。Pearson相关分析结果显示,成人哮喘患者血清25(OH)D水平与Dmin呈正相关(r=0.300,P<0.001)。结论血清25(OH)D水平与成人哮喘患者肺通气功能无关,但与Dmin呈正相关,故血清25(OH)D水平对评估成人哮喘患者气道高反应性(AHR)具有一定参考价值。

Correlation of Serum 25(OH)D Level with Pulmonary Ventilation Function and Minimum Induced Cumulative Dose in Adult Patients with Bronchial Asthma

Background Vitamin D(VitD)is an effective immunomodulator.Its deficiency is related to airway inflammation,aggravation and poor prognosis in patients with bronchial asthma(hereinafter referred to as asthma).At present,there are few reports on the correlation between adult asthma and VitD,and the research results are inconsistent.Objective To analyze the correlation of serum 25-hydroxyvitamin D25(OH)D]level with pulmonary ventilation function and minimum induced cumulative dose(Dmin)in adult patients with asthma.Methods This study was a retrospective study.A total of 179 newly diagnosed asthma patients treated in the First Affiliated Hospital of Xinjiang Medical University from January 2020 to September 2021 were selected as the observation group,and 151 healthy people who underwent physical examination in the First Affiliated Hospital of Xinjiang Medical University in the same period were selected as the control group.The serum 25(OH)D level of the two groups was compared,the pulmonary ventilation function indexesforced vital capacity(FVC),percentage of FVC in the predicted value,forced expiratory volume in one second(FEV₁),percentage of FEV₁ in the predicted value,FEV₁/FVC,percentage of FEV₁/FVC in the predicted value,peak expiratory flow(PEF),percentage of PEF in the predicted value,and percentage of forced expiratory flow at 25%of FVC exhaled(FEF₂₅),forced expiratory flow at 50%of FVC exhaled(FEF₅₀),forced expiratory flow at 75%of FVC exhaled(FEF₇₅),maximal mid-expiratory flow(MMEF)in the predicted value]and Dmin were compared in asthma patients with different serum 25(OH)D levels.The correlation between serum 25(OH)D level and Dmin in adult patients with asthma was analyzed by Pearson correlation analysis.Results The serum 25(OH)D level in the observation group was lower than that in the control group(P<0.05).There was no significant difference in FVC,percentage of FVC in the predicted value,FEV₁,percentage of FEV₁ in the predicted value,FEV₁/FVC,percentage of FEV₁/FVC in the predicted value,PEF,percentage of PEF in the predicted value,and percentage of FEF₂₅,FEF₅₀,FEF₇₅,MMEF in the predicted value in asthma patients with different serum 25(OH)D levels(P>0.05).The Dmin of asthma patients with insufficient and deficient serum 25(OH)D level was lower than that of asthma patients with normal serum 25(OH)D level,and the Dmin of asthma patients with insufficient serum 25(OH)D level was lower than that of asthma patients with insufficient serum 25(OH)D level(P<0.05).Pearson correlation analysis showed that,the serum 25(OH)D level in adult patients with asthma was positively correlated with the Dmin(r=0.300,P<0.001).Conclusion Serum 25(OH)D level is not related to pulmonary ventilation function in adult patients with asthma,but is positively correlated with the Dmin.Therefore,serum 25(OH)D level has a certain reference value for evaluating airway hyperresponsiveness in adult patients with asthma.