Department of Health Promotion/MPH Program, College of Health Sciences, University of Texas, El Paso, TX 79902-0581, USA.
Salud Publica Mex. 2010 May-Jun;52(3):185-9. doi: 10.1590/s0036-36342010000300001.
To assess the effect of micronutrient supplementation on tuberculosis (TB) patient outcomes.
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 mRNA), and sputum smear conversion were measured.
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.
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.
评估补充微量元素对肺结核（TB）患者结局的影响。
本随机、双盲、安慰剂对照研究在墨西哥奇瓦瓦州华雷斯市 IMSS 接受直接观察治疗短期疗程/严格监督短程化疗（TAES/DOTS）的肺结核患者中进行，这些患者于 2005 年 8 月至 2006 年 7 月期间入组。连续患者接受锌和维生素 A 补充剂或匹配的安慰剂治疗 4 个月。测量膳食摄入、血液锌和维生素 A、免疫反应（IFN-γ、TNF-α 和 IL-10 mRNA）以及痰涂片转化。
与安慰剂组相比，第 3 个月时痰涂片阴性的微量元素组患者的比例显著增加（p=0.03）。这发生在第 2 个月观察到 TNF-α和 IFN-γ增加以及 IL-10 减少之后。微量元素补充似乎加速了化疗的有益治疗效果。
从痰液中更早地消除细菌与改善锌状态和 Th1 免疫反应有关。维生素 A 的治疗效果不太明显。
