摘要
目的探讨咳嗽变异性哮喘(cough variant asthma,CVA)病情进展与患儿血清微量元素锌、钙水平和免疫功能的关系。方法选取2017年10月至2018年11月中国人民解放军中部战区总医院收治的156例CVA患儿为研究对象,将其中缺乏血清微量元素锌、钙中的1种或2种的104例患儿按照治疗方式不同分为观察1组(52例)和观察2组(52例),另将该院同期经检测不缺乏任何血清微量元素的52例CVA患儿纳入对照组。三组患儿均行皮质激素类药物治疗,观察1组患儿加服锌、钙制剂。观察并比较三组患儿治疗前后血清锌、钙和T细胞亚群水平、病情状况及治疗后1年病情进展情况。结果治疗后,观察1组和观察2组患儿血清锌、钙、CD3^+T细胞和CD8^+T细胞水平均显著高于本组治疗前(均P<0.05),CD4^+T细胞水平和CD4^+T细胞/CD8+T细胞比值均显著低于本组治疗前(均P<0.05);且观察1组患儿血清锌、钙和CD3+T细胞水平均显著高于观察2组(均P<0.05),CD4^+T细胞/CD8^+T细胞比值显著低于观察2组(P<0.05)。治疗后,三组患儿过敏原反应性咳嗽时间、夜间咳嗽时间、咳嗽持续时间、运动后咳嗽时间均显著短于本组治疗前(均P<0.05),观察2组患儿上述时间均显著长于对照组和观察1组(均P<0.05),观察1组和对照组患儿上述时间比较差异均无统计学意义(均P>0.05)。治疗后1年,三组患儿喘息、哮喘发生率和复发率比较差异均有统计学意义(均P<0.05),且观察2组患儿喘息、哮喘发生率和复发率均显著高于对照组和观察1组(均P<0.05),观察1组和对照组患儿上述指标比较差异均无统计学意义(均P>0.05)。结论及时补充缺乏的微量元素锌、钙有利于缩短CVA患儿咳嗽时间,降低复发率,延缓疾病进展。
Objective To explore the relationship between the progression of cough variant asthma(CVA)and serum microelement Zn and Ca and immune function in children with CVA.Method From October 2017 to November 2018,156 CVA children admitted to the General Hospital of the Central Theater of the Chinese People's Liberation Army were selected as the study subjects,104 children with deficiency of one or two serum microelement Zn and Ca were divided into observation group 1(n=52)and observation group 2(n=52)according to the different treatment methods,another 52 cases of CVA children without any serum microelement treated in that hospital during the same period were included in control group.All children among three groups were treated with corticosteroids,and the children in observation group 1 were given Zn and Ca preparation.The levels of serum Zn,Ca and T cell subsets,the condition and the progress of the disease were observed and compared among the three groups before and after treatment.Result After treatment,the levels of serum Zn,Ca,CD3^+T cell,CD8^+T cell of observation group 1 and observation group 2 were significantly higher than those before treatment(all P<0.05),CD4^+T cell level and CD4^+T cell/CD8^+T cell ratio were significantly lower than those before treatment(all P<0.05).The levels of serum Zn,Ca and CD3^+T cell of observation group 1 were significantly higher than those of observation group 2(all P<0.05),CD4^+T cell/CD8^+T cell ratio was significantly lower than that of observation group 2(P<0.05).After treatment,the duration of allergic cough,nocturnal cough,persistent cough and post-exercise cough among the three groups were significantly shorter than those before treatment(all P<0.05).The above indexes of observation group 2 were significantly longer than those of control group and observation group 1(all P<0.05).There were no significant differences in above indexes between observation group 1 and control group(all P>0.05).One year after treatment,there were significant differences in gasping rate,asthma rate and recurrence rate among the three groups(all P<0.05).The gasping rate,asthma rate and recurrence rate of observation group 2 were significantly higher than those of control group and observation group 1(all P<0.05).There were no significant differences in above indexes between observation group 1 and the control group(all P>0.05).Conclusion Timely supplement of deficient microelement Zn and Ca is beneficial to shorten the cough time,reduce the recurrence rate and delay the disease progression in children with CVA.
作者
丁冬胜
王丽
姜勇超
Ding Dongsheng;Wang Li;Jiang Yongchao(Department of Pediatrics,General Hospital of the Central Theater of the Chinese People's Liberation Army,Wuhan 430070,China;Department of Pediatrics,Hubei Maternal and Child Health Hospital,Wuhan 437600,China;Department of Pediatrics,Xiangyang Central Hospital,Hubei,Xiangyang 441021,China)
出处
《中国医学前沿杂志（电子版）》
2020年第5期131-135,共5页
Chinese Journal of the Frontiers of Medical Science(Electronic Version)
作者简介
通信作者:姜勇超,E-mail:jyc1208@126.com。
