Adjunctive micronutrient supplementation for pulmonary tuberculosis
Adjunctive micronutrient supplementation for pulmonary tuberculosis
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DOI：
10.1590/s0036-36342010000300001
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发表时间：
2010-06-01
期刊：
影响因子：
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通讯作者：
Campos, Armando
中科院分区：
文献类型：
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作者：
Armijos, Rodrigo X;Weigel, M Margaret;Campos, Armando
目标。评估微量营养素补充对结核病（TB）患者预后的影响。材料和方法。这项随机、双盲、安慰剂对照研究是在2005年8月至2006年7月期间在墨西哥奇瓦瓦州华雷斯市IMSS接受直接观察短期治疗/严格监督治疗（TAES/DOTS）的肺结核患者中进行的。连续4个月，患者服用锌和维生素A补充剂或相应的安慰剂。测定饮食摄入量、血锌和维生素A、免疫反应（ifn - γ、tnf - α和il - 10m RNA）和痰涂片转化率。结果。与第3个月痰涂片阴性的安慰剂组受试者相比，微量营养素的比例显着增加（p=0.03）。这是在第2个月观察到的tnf - α和ifn - γ增加和IL-10下降之后发生的。微量营养素的补充似乎可以加速化疗的有益治疗效果。结论。痰中杆菌的早期清除与锌状态和Th1免疫反应的改善有关。维生素A的治疗效果不太明显。
Objective. To assess the effect of micronutrient supplementation on tuberculosis (TB) patient outcomes. Material and Methods. The randomized, double-blinded, placebo-controlled study was conducted in pulmonary TB patients undergoing directly observed treatment short course/tratamiento acortado estrictamente supervisado (TAES/DOTS) at IMSS in Ciudad Juarez, Chihuahua, Mexico, who were recruited during August 2005-July 2006. Consecutive patients received zinc and vitamin A supplements or matched placebo for four months. Dietary intake, blood zinc and vitamin A, immune response (IFN-gamma,TNF-alpha, and IL-10 m RNA), and sputum smear conversion were measured. Results. The proportion of micronutrient compared to placebo group subjects with a negative sputum smear by month 3 was significantly increased (p=0.03). This occurred subsequent to increased TNF-alpha and IFN-gamma and decreased IL-10 observed at month 2. Micronutrient supplementation appeared to accelerate the beneficial therapeutic effect of chemotherapy. Conclusions. The earlier elimination of bacilli from sputum was associated with improved zinc status and Th1 immune response. The therapeutic effect of vitamin A was less evident.