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复发性喘息儿童的血清25-羟维生素D水平及其与喘息表型和频率的关系。

Serum 25-hydroxyvitamin D levels in children with recurrent wheezing and relation to the phenotypes and frequency of wheezing.

作者信息

Dogru M, Seren L P

机构信息

Zeynep Kamil Woman and Children' Diseases Training and Research Hospital, Department of Pediatrics, Burhanettin Ustunel Cad. 10 Uskudar, Istanbul, Turkey Phone: +90 505 270 35 14 Fax: +90 216 391 06 99 E-mail:

Zeynep Kamil Woman and Children' Diseases Training and Research Hospital, Department of Pediatrics, Istanbul, Turkey.

出版信息

Eur Ann Allergy Clin Immunol. 2017 Nov;49(6):257-262. doi: 10.23822/EurAnnACI.1764-1489.14.

Abstract

Recurrent wheezing may be related to various reasons. There is a lack of knowledge about the effect of vitamin D status in the children with recurrent wheezing. The aim of this study is to compare the level of vitamin D between recurrent wheezing children and healthy controls, and to investigate the relationship between vitamin D status and the clinical parameters of recurrent wheezing in preschool children. One hundred-ten children followed up in our hospital with recurrent wheezing were included in the study. The control group included fifty children without wheezing episodes. The serum 25-hydroxyvitamin D (25OHD) level was measured. The patients with recurrent wheezing were grouped according to their vitamin D status as "deficient group" and "non-deficient group (Vitamin D level is insufficient and normal)". We investigated the relationship between vitamin D status and the clinical and laboratory parameters of children with recurrent wheezing. Mean 25OHD level was 21.66 ± 8.13 ng/mL (5.6-53) in the study group and 25.36 ± 10.17 ng/mL (6-59) in the control group. The difference was statistically significant (p = 0.015). When the patients with recurrent wheezing were compared according to their vitamin D status, number of hospitalizations, number of positive sensitivity, percentage of eosinophil, serum IgE levels, Asthma Predictive Index positivity and wheezing phenotypes were not found to be different between groups. However, the duration of wheezing, the number of wheezing episodes and systemic glucocorticoid need in the previous year, and the total number of wheezing episodes were significantly higher in the deficient group (p < 0.05). The serum 25OHD level was negatively correlated with the duration of wheezing (r: -0.238; p: 0.012), total number of wheezing episodes (r: -0.436; p: 0.001), number of wheezing episodes in the previous year (r: -0.395; p: 0.001), and systemic glucocorticoid need in the previous year (r: -0.324; p: 0.001). Mean 25OHD levels were lower in patients with recurrent wheezing than in healthy controls. The duration of illness and number of wheezing episodes were correlated with vitamin D levels. An evaluation of the serum levels of vitamin D and supplementation if needed should be recommended in patients with recurrent wheezing, especially in those with long-term and frequent wheezing episodes.

摘要

复发性喘息可能与多种原因有关。目前对于维生素D状态在复发性喘息儿童中的作用缺乏了解。本研究的目的是比较复发性喘息儿童与健康对照者的维生素D水平,并探讨维生素D状态与学龄前儿童复发性喘息临床参数之间的关系。本研究纳入了在我院随访的110例复发性喘息儿童。对照组包括50例无喘息发作的儿童。检测血清25-羟基维生素D(25OHD)水平。将复发性喘息患者根据其维生素D状态分为“缺乏组”和“非缺乏组(维生素D水平不足和正常)”。我们研究了维生素D状态与复发性喘息儿童的临床和实验室参数之间的关系。研究组的平均25OHD水平为21.66±8.13 ng/mL(5.6 - 53),对照组为25.36±10.17 ng/mL(6 - 59)。差异具有统计学意义(p = 0.015)。当根据维生素D状态比较复发性喘息患者时,发现两组之间的住院次数、阳性敏感性数量、嗜酸性粒细胞百分比、血清IgE水平、哮喘预测指数阳性率和喘息表型并无差异。然而,缺乏组的喘息持续时间、前一年的喘息发作次数和全身糖皮质激素需求以及喘息发作总数均显著更高(p < 0.05)。血清25OHD水平与喘息持续时间(r: - 0.238;p:0.012)、喘息发作总数(r: - 0.436;p:0.001)、前一年的喘息发作次数(r: - 0.395;p:0.001)以及前一年的全身糖皮质激素需求(r: - 0.324;p:0.001)呈负相关。复发性喘息患者的平均25OHD水平低于健康对照者。疾病持续时间和喘息发作次数与维生素D水平相关。对于复发性喘息患者,尤其是那些有长期频繁喘息发作的患者,建议评估血清维生素D水平并在需要时进行补充。

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