血清1，25-（OH）2D3 和MMP-9 对哮喘患儿病情发生发展的影响

Effect of serum 1, 25-(OH)2D3 and MMP-9 on development of asthma in children

摘要:

目的 探讨哮喘患儿血清1，25- 二羟基维生素D3[1，25-（OH）2D3] 和基质金属蛋白酶9（MMP-9）水平对哮喘患儿病情发生发展的影响。方法 选取2014 年1 月-2016 年3 月广元市第三人民医院收治的62 例支气管哮喘患儿为研究对象，归为观察组，根据严重程度分为轻度组（n =17）和中重度组（n =45），并选取同期因呼吸道异物或先天畸形住院的30 例患儿作为对照组。采用酶联免疫吸附法测定并比较不同组别患儿的血清1，25-（OH）2D3 水平，以及血清、支气管肺泡灌洗液（BALF）的MMP-9 水平。根据血清1，25-（OH）2D3 水平将所有哮喘患儿分为维生素D（VD）正常组（>30μg/L，n =9）、VD不足组（20 ～ 30μg/L，n =15）及VD 缺乏组（<20μg/L，n =38），比较3 组的血清、BALF 的MMP-9 水平。采用Pearson 相关分析来探讨哮喘患儿血清1，25-（OH）2D3 水平与血清、BALF 的MMP-9 水平的关系。结果 ①观察组患儿的血清1，25-（OH）2D3 水平与对照组比较，差异有统计学意义（P <0.05），观察组低于对照组。观察组血清及BALF 的MMP-9 水平与对照组比较，差异有统计学意义（P <0.05），观察组高于对照组。②中重度组患儿的血清1，25-（OH）2D3 水平与轻度组比较，差异有统计学意义（P <0.05），中重度组低于轻度组。血清及BALF 的MMP-9 水平与轻度组比较，差异有统计学意义（P <0.05），中重度组高于轻度组。③ VD 正常组的血清与BALF 的MMP-9 水平与另外两组比较，差异有统计学意义（P <0.05），VD 正常组低于另外两组。VD 不足组的血清与BALF 的MMP-9 水平与VD 缺乏组比较，差异有统计学意义（P <0.05），VD 不足组低于VD 缺乏组。Pearson 相关分析结果表明哮喘患儿的血清1，25-（OH）2D3 水平与血清MMP-9 水平呈负相关，与BALF 的MMP-9 水平呈负相关。结论 哮喘患儿的血清1，25-（OH）2D3 水平下降，而血清及BALF 的MMP-9 水平升高，两者共同参与了患儿的呼吸道炎症反应和气道重塑过程，提高VD 水平可能有助于改善其病情。

Abstract:

Objective To investigate the effect of serum 1,25-dihydroxy vitamin D3 [1,25-(OH)2D3] and matrix metalloproteinase 9 (MMP-9) on the development of asthma in children. Methods Sixty-two children with asthma in the Third People’s Hospital of Guangyuan from January 2014 to March 2016 were enrolled into the study as observation group, and divided into the mild group (n = 17) and moderate to severe group (n = 45). Thirty children with tracheal foreign body or abnormal airway were selected as control group. The level of 1,25-(OH)2D3 in the serum and the levels of MMP-9 in the serum and bronchoalveolar lavage fluid (BALF) were measured by enzymelinked immunosorbent assay and compared among these groups. According to the serum 1,25-(OH)2D3 levels, all children with asthma were divided into normal vitamin D (VD) group (> 30 μg/L, n = 9), insufficient VD group (20-30 μg/L, n = 15) and deficient VD group (< 20 μg/L, n = 38), and the levels of MMP-9 in serum and BALF were compared between the three groups. Pearson correlation analysis was used to investigate the relationships of serum 1,25-(OH)2D3 level with serum and BALF MMP-9 levels in children with asthma. Results Serum 1,25-(OH)2D3 level in the observation group was significantly lower than that in the control group, while serum and BALF MMP-9 levels were significantly higher than those in the control group (P < 0.05). Serum 1,25-(OH)2D3 level in the moderate to severe group was significantly lower than that in the mild group, while serum and BALF MMP-9 levels were significantly higher than those in the mild group (P < 0.05). Serum and BALF MMP-9 levels in the normal VD group were significantly lower than those in the other two groups, and serum and BALF MMP-9 levels in the insufficient VD group were significantly lower than those in the deficient VD group (P < 0.05). Pearson correlation analysis result showed that serum 1,25-(OH)2D3 level of children with asthma was negatively correlated with MMP-9 levels in the serum and BALF (P < 0.05). Conclusions Serum 1,25-(OH)2D3 level of children with asthma is significantly decreased while serum and BALF MMP-9 levels significantly increase, so they are both involved in airway inflammation and remodeling in children with asthma, and increasing VD level may help to improve the condition of the children.