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- 2015

维生素D佐治老年人社区获得性肺炎的临床研究

DOI: doi:10.7507/1671-6205.2015119

刘萍

Keywords: 维生素D, 社区获得性肺炎, 老年人

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Abstract:

目的探讨维生素D(VitD)佐治老年人社区获得性肺炎(CAP)的临床疗效。方法选择老年CAP患者104例, 随机分为VitD治疗组和安慰剂对照组, 每组各52例, 以同期体检的78例健康老年人作对照。应用酶联免疫吸附法检测血清中25羟维生素D3[25-(OH)D3]水平, 应用免疫透射比浊法检测血清中免疫球蛋白A(IgA)及C反应蛋白(CRP)水平, 记录和比较CAP患者的临床症状、体征、实验室、影像学检查的变化情况及住院天数。结果CAP患者治疗前血清25-(OH)D3、IgA和CRP水平分别为(25.22±8.68) nmol/L、(0.28±0.06) g/L和(119.50±21.76) mg/L, 其中血清25-(OH)D3和IgA水平均明显低于正常对照组(t=25.213, P＜0.05;t=22.280, P＜0.05), 而血清CRP水平显著高于正常对照组(t=-47.114, P＜0.05), 且CAP患者血清25-(OH)D3水平与血清IgA水平呈正相关(r=0.829, P＜0.05)。同安慰剂对照组相比, VitD治疗组患者血清CRP水平降低, 临床总有效率提高了34.4%, 住院天数缩短了25.1%, 且三项指标组间比较差异均有统计学意义(t=5.017, P＜0.05;χ2=4.248, P＜0.05;t=6.321, P＜0.05)。VitD治疗组患者治疗后血清25-(OH)D3和IgA水平分别为治疗前的2.84倍和1.96倍。安慰剂对照组患者治疗前后血清25-(OH)D3和IgA水平差异无统计学意义。结论VitD缺乏可能是老年CAP的潜在病因, 补充足量VitD可缓解CAP患者临床症状, 明显缩短病程

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