Abstract: Objective To investigate the effect of different doses of vitamin D₃ on T lymphocyte subsets in children with bronchial asthma and on the improvement of asthma control levels,and to explore the mechanism and optimal dose of vitamin D₃ in the treatment of bronchial asthma in children. Methods A total of 120 children with bronchial asthma aged from 6 to 13 years were selected.In addition,30 healthy children were selected as the normal control group in the same period.The selected patients were randomly divided into 4 groups,including one group of conventional treatment and three groups of vitamin D₃ treatment on the basis of conventional treatment.The doses of vitamin D₃ were 400 U,600 U and 800 U per day,respectively,and the total course of treatment was 12 months.The T lymphocyte subsets were detected before treatment,1 month,3 months,6 months and 12 months after treatment.The control level of asthmatic children was counted at 12 months after treatment. Results After 12 months,the levels of CD4,CD4/CD8 in blood were significantly lower than those before treatment,and CD8 was significantly elevated,but compared with the control group,there were still significant differences.After 6 months of treatment,in the 600 U and 800 U treatment groups,the levels of CD4 and CD4/CD8 were decreased more significantly than the other two groups.The asthma control level of the 600 U and 800 U treatment group was significantly higher than that of the other two groups after treatment,but there was no significant difference between the 600 U and 800 U groups (P>0.05). Conclusions Oral intake of different doses of vitamin D₃ can regulate the imbalance of T lymphocyte subsets,which is one of the mechanisms of vitamin D₃ in the treatment of asthma,but it still requires a long process.Vitamin D₃ treatment significantly improved the control level of asthma,daily intake of 600 U may be the best treatment dosage.

Key words: bronchial asthma, vitamin D₃, T lymphocyte, children

摘要： 目的 研究口服不同剂量维生素D₃(VitD₃)对支气管哮喘患儿T淋巴细胞的调节,及对哮喘控制水平的改善,进而分析VitD₃治疗儿童哮喘的机理及最佳剂量。方法 选取6～13岁哮喘患儿120例,另外选择同期进行健康体检儿童30例作为正常对照。入选患儿随机分为4组,常规治疗组1组,VitD₃治疗组3组,后者在常规治疗的基础上口服VitD₃治疗,剂量分别为每日400 U、600 U、800 U,总疗程12个月。分别于治疗前、治疗后的1、3、6、12个月检测患儿血T淋巴细胞亚群。疗程达12个月时统计患儿的哮喘控制水平。结果 疗程12个月后各组CD4、CD4/CD8均较治疗前显著降低,CD8较前显著升高,但与正常对照组比较差异有统计学意义(P<0.05);疗程达6个月时,600 U及800 U治疗组CD4及CD4/CD8较另外两组显著降低。疗程达12个月时,600 U及800 U治疗组的哮喘控制水平显著高于另外两组,而600 U及800 U间差异无统计学意义(P>0.05)。结论 口服不同剂量VitD₃均能调节哮喘患儿T淋巴细胞的失衡,这是VitD₃治疗哮喘的机制之一,但需要较长期的过程;VitD₃治疗显著改善哮喘的控制水平,每日600 U可能为最佳的治疗剂量。

关键词: 支气管哮喘, 维生素D₃, T淋巴细胞, 儿童