补充维生素D对轻度至中度持续性哮喘患者气道功能的影响
2014/10/17
摘要
背景：假说认为维生素D在先天免疫和适应性免疫、炎症减轻和重塑方面有一定作用；因此，它被认为会影响哮喘的表型、严重程度以及对吸入皮质类固醇（ICS）的反应。
目的：研究旨在探索在哮喘控制药物（ICS或ICS加长效β受体-激动剂）以外补充维生素D对气道功能的协同效应。
方法：一项随机临床试验，纳入130例年龄在10至50岁，在居住德黑兰居住24周的患者。收集纳入人群的年龄、性别、身体质量指数、哮喘阶段、血清总IgE、过敏性鼻炎病史、特应性皮炎、食物过敏、荨麻疹信息。收集干预前、治疗8周和24周的肺功能参数（1秒用力呼气量 [FEV1]与FEV1和用力肺活量的比值）和血清维生素D的测量值。患者被随机分为2组。两组患者根据他们的疾病阶段接受哮喘控制药物（布地奈德或布地奈德加福莫特罗），但干预组除接受哮喘控制药物外补充维生素D（肌肉注射100000单位加每周口服一次50000单位）
结果：治疗8周后，两组FEV1均显著改善，两组在基线（P =0.20）或治疗8周（P=0.99）时EFV1无显著差异；然而，干预组在过去16周显著改善，治疗24周后，干预组较其他组FEV1显著改善（P <0.001）。
结论：补充维生素D并联合哮喘控制药物治疗24周，可以显著改善轻度至中度持续性哮喘患者的FEV1。
（苏楠 审校）
AnnAllergyAsthmaImmunol.2014Aug1.pii:S1081-1206(14)00463-3.doi:10.1016/j.anai.2014.07.005. [Epub ahead of print]
The effects of vitamin D supplementation on airway functions in mild to moderate persistent asthma.
Arshi S1, Fallahpour M2, Nabavi M1, Bemanian MH1, Javad-Mousavi SA3, Nojomi M4, Esmaeilzadeh H1, Molatefi R1, Rekabi M1, Jalali F1, Akbarpour N1.
ABSTRACT
BACKGROUND: Vitamin D is hypothesized to have some roles in innate and adaptive immunity, inflammation reduction, and remodeling; therefore, it is supposed to affect the asthma phenotype, severity, and response to inhaled corticosteroid (ICS).
OBJECTIVE: To explore the synergistic effects of vitamin D supplementation in addition to asthma controllers (ICS or ICS plus long-acting β-agonist) on airway functions.
METHODS: A randomized clinical trial was conducted in 130 individuals aged 10 to 50 years who lived in Tehran during a 24-week period. Data on age, sex, body mass index, stage of asthma, serum total IgE, history of allergic rhinitis, atopic dermatitis, food allergy, and urticaria were collected. Spirometric parameters (forced expiratory volume in 1 second [FEV1] and ratio of FEV1 to forced vital capacity) and serum vitamin D measurement were obtained before and 8 and 24 weeks after the intervention. Patients were divided in 2 groups randomly. Both groups received asthma controllers (budesonide or budesonide plus formoterol) according to their stage, but the intervention group received vitamin D supplementation (100,000-U bolus intramuscularly plus 50,000 U orally weekly) in addition to asthma controllers.
RESULTS: FEV1 improved significantly in both groups after 8 weeks, but no significant difference was found between the 2 groups at baseline (P = .20) or after 8 weeks (P = .99); however, a significant improvement was seen in the intervention group in the last 16 weeks, and FEV1 was significantly better in the intervention group than the other group after 24 weeks (P < .001).
CONCLUSION: Vitamin D supplementation associated with asthma controllers could significantly improve FEV1 in mild to moderate persistent asthma after 24 weeks.
AnnAllergyAsthmaImmunol.2014Aug1.pii:S1081-1206(14)00463-3.doi:10.1016/j.anai.2014.07.005. [Epub ahead of print]
