目的：分析哮喘患儿血清25羟维生素 D3[25-（OH）D3]水平与病情严重程度及气道炎性反应之间的关联性。方法：选择92例哮喘患儿（轻、中、重度各25、38、29例）和28例健康儿童，用酶联免疫吸附试验（ELISA ）检测入组儿童的血清25-（OH）D3水平。治疗1个月后采用儿童哮喘控制测试量表（C-ACT）评价患儿哮喘的控制情况，并用纤维支气管镜收集患儿肺泡灌洗液（BALF），检测其中炎性因子和炎性细胞的分类和数量。结果：健康组以及轻、中、重度患儿组血清25-（OH）D3水平分别为43．5 nmol／L 、34．5 nmol／L 、31．6 nmol／L 和22．3 nmol／L ，组间差异有统计学意义（P＜0．05）；血清25-（OH）D3水平在哮喘完全控制、部分控制、无法控制3组中分别为（32．5±5．34）、（22．2 ± 3．92）、（18．1 ± 4．33） nmol／L ，且组间差异有统计学意义（P＜0．05） 。 轻、中、重度哮喘患儿 BALF 上清液中中性粒细胞比例、嗜酸性粒细胞比例以及肿瘤坏死因子α（TNF-α）、白细胞介素-6（IL-6）、IL-8浓度逐渐增加，组间比较差异有统计学意义（P＜0．05）；但 BALF 上清液中淋巴细胞比例和血清25-（OH）D3水平逐渐降低，组间差异也有统计学意义（P＜0．05）。结论：血清25-（OH）D3水平与哮喘患儿的病情严重程度、哮喘控制情况之间以及哮喘患儿的病情严重程度与慢性炎性反应之间均存在关联性。%Objective :To analyze the correlations among serum 25-hydroxyvitamin D3 (25-(OH)D3 ) level ,disease severity and airway inflammatory response of children with asthma . Methods :Ninety-two cases of mild , moderate ,and severe asthma children and 28 healthy children were selected .The serum 25-(OH)D3 levels of enrolled children were detected by enzyme-linked immunosorbent assay (ELISA) .The status of asthma control was determined by Childhood Asthma Control Test (C-ACT ) in one month after therapy .And the bronchoalveolar lavage fluid(BALF) was collected by fiber bronchoscopy ,so that the classification and quantity of inflammatory cytokines and inflammatory cells were detected .Results :The levels of serum 25-(OH)D3 in control group ,mild group ,moderate group and severe group were 43 .5 nmol/L ,34 .5 nmol/L ,31 .6 nmol/L ,and 22 .3 nmol/L ,respectively .And there were significant differences among the groups (P< 0 .05) .The serum 25-(OH)D3 levels in full control group ,part of control group ,and out of control group were (32 .5 ± 5 .34) nmol/L ,(22 .2 ± 3 .92) nmol/L , (18 .1 ± 4 .33) nmol/L ,respectively .And there were significant differences among these groups (P < 0 .05) .In accordance with the severity of disease ,the proportions of neutrophil and eosinophil ,and the concentrations of TNF-α ,IL-6 and IL-8 increased gradually in BALF supernatants .And there were significant differences among the groups (P< 0 .05) .However ,the proportion of lymphocytes and the serum 25-(OH) D3 level decreased gradually ,and there were significant differences among the groups (P< 0 .05) .Conclusions :The serum 25-(OH)D3 level was significantly correlated with the severity of asthma ,as well as the status of asthma control in children with asthma . And the disease severity is also correlated with chronic inflammatory response .
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