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Chest:维生素D缺乏是否影响合并ABPA的哮喘患者的Th2应答?

2017-11-17 吴星 环球医学

2017年10月,发表在《Chest》的一项研究考察了哮喘合并和不合并过敏性支气管肺曲菌病(ABPA)患者中的维生素D水平。

2017年10月,发表在《Chest》的一项研究考察了哮喘合并和不合并过敏性支气管肺曲菌病(ABPA)患者中的维生素D水平。

目的:较低的血清维生素D水平与囊性纤维化合并ABPA患者增高的Th2应答相关。尚不清楚与不合并ABPA的哮喘患者相比,维生素D水平是否在合并ABPA的哮喘患者中较低。本研究中,研究者评估了哮喘合并和不合并ABPA患者的维生素D(25OHD3)水平。

方法:本研究方案获得了医院伦理委员会的获准,所有研究对象都签署了知情同意。ABPA合并哮喘的连续患者需要提供详细的临床病史,并评估了维生素D、IgE水平,并测量了肺活量。使用哮喘控制调查问卷7评估哮喘控制。维生素D缺乏的定义为25HOD3水平<20 ng/mL。

结果:158例ABPA(78名男性,平均年龄35.9岁)和75例哮喘不合并ABPA(39名男性,平均年龄39.4岁)患者纳入本研究。合并(平均[95% CI],18.9[16.9~20.8]ng/mL)和不合并(平均[95% CI],19.2[16.3~22.1]ng/mL)ABPA的哮喘患者的维生素D水平无差异。151例(64.8%)患者维生素D缺乏,两组相似(哮喘vs ABPA:103[65.2%] vs 648[64%])。哮喘控制调查问卷(平均[95% CI],3.7[3.4~4.1] vs 3.3[2.8~3.8])、肺功能(平均[95% CI]FEV1[L]:1.9[1.7~2.0] vs 1.9[1.8~2.2])、总IgE(平均[95% CI],9595[8086~11104] vs 7455[5843~9067]IU/mL)、烟曲霉特异性IgE水平(平均[95% CI],44.5[27.7~61.3] vs 27.0[21.9~32.2]kUA/L)、嗜酸性粒细胞计数(平均[95% CI],1260[1038~1483] vs 1501[1156~1529]个细胞/μL)、支气管扩张程度(平均[95% CI],8.9[7.8~10.1] vs 7.8[6.3~9.4]部分)、高衰减黏液发生率(34.9% vs 30.9)在具有(n=103)和不具有(n=55)维生素D缺乏的ABPA患者中无差异。

结论:数据并未表明,维生素D状态在哮喘合并和不合并ABPA的患者中存在差异。

原始出处:

Ritesh Agarwal, Ashutosh Aggarwal, Sanjay Bhadada, et al. Vitamin D Levels in Asthmatic Patients With and Without Allergic Bronchopulmonary Aspergillosis. Chest, 2017.

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    2018-06-20 Smile2680
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    2017-12-18 仁医06
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    2017-12-03 wleon8895
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    2018-04-09 zhlpower

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