Burkiewicz Claudine Juliana Cristina Caznoch, Guadagnin Fernanda Ampesaan, Skare Thelma Laroka, do Nascimento Marcelo Mazza, Servin Santiago Cirilo Nogueira, de Souza Gleim Dias
Evangelical Faculty of Paraná / Evangelical UniversityHospital of Curitiba, Brazil.
Rev Col Bras Cir. 2012 Sep-Oct;39(5):401-7. doi: 10.1590/s0100-69912012000500011.
To analyze the relation between vitamin D insufficiency and wound healing in patients with venous ulcers; to correlate vitamin D insufficiency with characteristics of the ulcer (size and pain) and to evaluate if reposition of vitamin D in these subjects expedites ulcer healing.
We selected 26 patients with leg ulcers, and 26 control patients without ulcers, matched for gender, age, systemic arterial hypertension and tobacco use. The venous ulcer group was divided in two subgroups: one that received placebo (nine patients) and other receiving vitamin D, 50.000 IU per week over two months (13 patients). Blood was collected for 25 OH vitamin D dosage before and after the medication. In the ulcer group, we obtained data concerning demographics, leg ulcer size, as well as pain severity, measured by an analogical visual scale. Data was grouped in contingency and frequency tables, the tests of Fisher and chi-squared being used for nominal variables and Mann-Whitney for numerical variables. The adopted significance was of 5%.
We found vitamin D insufficiency in the great majority of the patients. The median level in the ulcer group was 17.05 ng/dl and 22.75 ng/dl in the group without ulcer (p=0,0182) No relation was found between the ulcer size without treatment and the level of vitamin D. After treatment, the average size of the ulcer changed from 25 cm² to 18 cm² in the patients that took vitamin D and from 27 cm² to 24,5 cm² in the placebo group (p=0,7051 and p=0,7877, respectively). Considering the variability of the size of the ulcer in the treatment group versus placebo group, the average size was equal to -0,75 cm² in the first group and +4cm² in the second (p=0,0676)
Patients with leg ulcers have more vitamin D deficiency. No difference in the ulcer characteristics was noted between those with and without vitamin D deficiency. There was a trend toward a better healing in those with vitamin D reposition.
分析维生素D缺乏与静脉性溃疡患者伤口愈合之间的关系；将维生素D缺乏与溃疡特征（大小和疼痛）相关联，并评估补充维生素D是否能加速这些患者的溃疡愈合。
我们选取了26例腿部溃疡患者和26例无溃疡的对照患者，两组在性别、年龄、系统性动脉高血压和吸烟情况方面相匹配。静脉性溃疡组分为两个亚组：一组接受安慰剂治疗（9例患者），另一组接受维生素D治疗，每周50000 IU，持续两个月（13例患者）。在用药前后采集血液进行25-羟维生素D检测。在溃疡组，我们获取了有关人口统计学、腿部溃疡大小以及通过视觉模拟量表测量的疼痛严重程度的数据。数据被整理成列联表和频率表，对于名义变量使用Fisher检验和卡方检验，对于数值变量使用Mann-Whitney检验。采用的显著性水平为5%。
我们发现绝大多数患者存在维生素D缺乏。溃疡组的中位数水平为17.05 ng/dl，无溃疡组为22.75 ng/dl（p = 0.0182）。未发现未经治疗的溃疡大小与维生素D水平之间存在关联。治疗后，服用维生素D的患者溃疡平均大小从25 cm²变为18 cm²，安慰剂组从27 cm²变为24.5 cm²（分别为p = 0.7051和p = 0.7877）。考虑到治疗组与安慰剂组溃疡大小的变异性，第一组的平均大小变化为 -0.75 cm²，第二组为 +4 cm²（p = 0.0676）
腿部溃疡患者维生素D缺乏更为常见。维生素D缺乏患者与非缺乏患者在溃疡特征方面未发现差异。补充维生素D的患者有愈合更好的趋势。
