在肺结核的强化阶段抗微生物治疗期间高剂量维生素D:一项双盲随机对照试验
Adrian R Martineau1, Peter M Timms, Graham H Bothamley
1Queen Mary University of London, Barts and The London School of Medicine and Dentistry, London, UK. a.martineau@qmul.ac.uk
Lancet (London, England)
|January 11, 2011
概括
对所有患者来说,维生素D补充剂并没有显著缩短结核病治疗时间. 然而,它在具有特定维生素D受体基因变异 (TaqI tt基因型) 的个体中加速了唾液培养转化.
科学领域:
- 肺部医学 肺部医学
- 传染性疾病 传染性疾病
- 营养科学 营养科学
背景情况:
- 维生素D历来治疗结核病及其代谢产物显示出体外抗菌性质.
- 在临床试验中,辅助维生素D对唾液培养转换的影响仍未得到充分研究.
研究的目的:
- 评估辅助维生素D3在加快肺结核成年人的液培养转化中的疗效.
- 研究维生素D受体 (VDR) 基因多态 (TaqI和FokI) 对治疗反应的影响.
主要方法:
- 一个多中心随机对照试验,涉及146名液涂抹阳性肺结核的成年人.
- 参与者在42天内接受了标准结核病治疗,再加上维生素D3 (2.5毫克剂量) 或安慰剂.
- 进行了TaqI和FokI VDR多态的基因型鉴定,以分析基因型特异性治疗效应.
主要成果:
- 与安慰剂相比,维生素D3补充剂显著增加了血清25-基维生素D水平.
- 在整个研究人群中,没有观察到液培养转换的中位时间有显著差异.
- 在TaqI tt基因型 (p=0.02) 的患者中,观察到唾液培养转换的显著加快.
结论:
- 在结核病治疗期间,辅助维生素D3有效提高了血清维生素D水平.
- 维生素D补充剂并没有普遍缩短唾液培养转换时间,但在TaqI tt VDR基因型患者中显示出显著的益处.
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