Natchu Uma Chandra Mouli, Fataki Maulidi R, Fawzi Wafaie W
Department of Nutrition, Harvard School of Public Health, Boston, Massachussets 02115, USA.
Nutr Rev. 2008 Jul;66(7):398-405. doi: 10.1111/j.1753-4887.2008.00049.x.
Zinc supplementation has been consistently shown to reduce the incidence of childhood pneumonia, but its effect on the course of pneumonia when administered as an adjunct to antibiotic therapy is still unclear. Three trials published to date have shown mixed results, and a recent trial from India raises the possibility that zinc may be detrimental in some circumstances. Study sites and designs differ, particularly in the timing of zinc treatment and in determining recovery from pneumonia, which can explain the differences in study findings. Serum zinc concentrations are unreliable indicators of zinc status, particularly during acute infectious illnesses. Subgroup analyses, especially using serum zinc levels, must be cautioned against. Future studies are needed that are large enough to be sufficiently powered to accommodate larger treatment failure rates, an issue that ongoing trials will hopefully address.
一直以来，补锌都被证明可降低儿童肺炎的发病率，但作为抗生素治疗的辅助手段时，其对肺炎病程的影响仍不明确。迄今为止发表的三项试验结果不一，印度最近的一项试验提出，在某些情况下锌可能有害。研究地点和设计各不相同，尤其是在补锌治疗的时间以及判定肺炎康复方面，这可以解释研究结果的差异。血清锌浓度并非锌状态的可靠指标，尤其是在急性感染性疾病期间。必须警惕亚组分析，尤其是使用血清锌水平进行的亚组分析。未来需要开展规模足够大、有足够效力以适应更高治疗失败率的研究，目前正在进行的试验有望解决这一问题。
