学龄期儿童维生素D水平与支气管哮喘及与其肺通气功能、FeNO的关系的研究

Study on the Relationship between Vitamin D Levels in School-Age Children and Bronchial Asthma, Pulmonary Ventilation Function, and FeNO

摘要: 目的：研究学龄期儿童血清维生素D水平与支气管哮喘的关系，探究维生素D水平与肺通气功能、呼出气一氧化氮(FeNO)、外周血嗜酸性粒细胞(EOS)及血清总IgE的关系，明确维生素D水平与哮喘严重程度、哮喘控制水平之间的关系，为儿童支气管哮喘的预防及治疗提供参考依据。方法：选取本院自2023年10月~2025年8月间收治的80例首次来我院儿科门诊及入院确诊为支气管哮喘的学龄期患儿作为研究对象观察组；并同时选取同期于我院儿科门诊体检中发现的30例正常学龄期儿童作为参照组。检测两组血清25羟维生素D3 [25(OH)D3]、总IgE水平，外周血EOS计数，肺通气功能指标[用力肺活量(FVC)、第一秒最大呼气量(FEV1)、FEV1/FVC%等]和FeNO值。对比两组维生素D水平，分析试验组维生素D水平与上述各指标、哮喘严重程度、哮喘控制水平的关系。结果：试验组血清25(OH)D3水平(18.62 ± 5.38 ng/mL)低于对照组(26.85 ± 6.12 ng/mL)，相比差异具有统计学意义(P < 0.05)。试验组中维生素D缺乏组(<20 ng/mL) 52例，不足组(20~30 ng/mL) 23例，充足组(≥30 ng/mL) 5例；缺乏组FEV1、FEV1/FVC%、MEF50等肺通气功能指标明显低于不足组与充足组，FeNO值、EOS计数及总IgE水平明显高于不足组与充足组，相比差异均具有统计学意义(P < 0.05)。相关性分析发现，血清25(OH)D3水平与FEV1、FEV1/FVC%呈正相关，与FeNO值、EOS计数、总IgE水平呈负相关(P < 0.05)。哮喘重症患儿维生素D水平明显低于轻中症患儿，未控制组明显低于部分控制组与完全控制组，比较差异均有统计学意义(P < 0.05)。结论：儿童学龄期支气管哮喘患者常存在维生素D缺乏情况，维生素D缺乏可能是导致哮喘发生的一个因素，维生素D水平与肺功能呈正相关，与气道炎症指标(FeNO、EOS、总IgE)呈负相关，并且会影响哮喘病情的严重程度以及哮喘是否被良好地控制。临床上可将维生素D水平检测纳入哮喘评估的检查项目当中，适当补充维生素D有利于哮喘儿童的气道功能以及哮喘病情的控制。

Abstract: Objective: To investigate the relationship between serum vitamin D levels and bronchial asthma in school-aged children, explore the associations between vitamin D levels and pulmonary ventilation function, exhaled nitric oxide (FeNO), peripheral blood eosinophils (EOS), and total serum IgE, clarify the correlation between vitamin D levels and asthma severity as well as asthma control status, and provide reference evidence for the prevention and treatment of pediatric bronchial asthma. Methods: A total of 80 school-aged children diagnosed with bronchial asthma for the first time at our hospital’s pediatric outpatient department or hospitalized between October 2023 and August 2025 were enrolled as the study group, while 30 healthy school-aged children identified during routine physical examinations at the same period served as the control group. Serum levels of 25-hydroxyvitamin D3 [25(OH)D3], total IgE, peripheral blood EOS count, pulmonary ventilation parameters [forced vital capacity (FVC), first-second forced expiratory volume (FEV1), FEV1/FVC%, etc.], and FeNO levels were measured in both groups. Vitamin D levels were compared between groups, and the relationships between vitamin D levels and the aforementioned parameters, asthma severity, and asthma control status were analyzed. Results: The serum 25(OH)D3 level in the study group (18.62 ± 5.38 ng/mL) was significantly lower than that in the control group (26.85 ± 6.12 ng/mL; P < 0.05). In the trial group, there were 52 cases with vitamin D deficiency (<20 ng/mL), 23 cases with insufficient levels (20~30 ng/mL), and 5 cases with adequate levels (≥30 ng/mL). The pulmonary ventilation parameters in the deficiency group—FEV1, FEV1/FVC%, and MEF50—were significantly lower than those in both the insufficient and adequate groups, whereas the FeNO level, eosinophil count, and total IgE level were significantly higher than those in the insufficient and adequate groups, with all differences being statistically significant (P < 0.05). Correlation analysis revealed that serum 25(OH)D3 levels were positively correlated with FEV1 and FEV1/FVC%, and negatively correlated with FeNO levels, eosinophil count, and total IgE levels (P < 0.05). Children with severe asthma exhibited significantly lower vitamin D levels compared to those with mild or moderate asthma, and the uncontrolled group showed significantly lower levels than both partially controlled and fully controlled groups, with all differences being statistically significant (P < 0.05). Conclusion: Pediatric patients with bronchial asthma often exhibit vitamin D deficiency, which may be a contributing factor to asthma onset. Vitamin D levels are positively correlated with pulmonary function and negatively correlated with airway inflammation markers (FeNO, eosinophils, total IgE), influencing both the severity of asthma and its control efficacy. Clinically, vitamin D testing should be incorporated into asthma assessment protocols, as appropriate supplementation may improve airway function and asthma control in pediatric patients.