Department of Pathology and Biomedical Science, University of Otago, Christchurch, New Zealand.
Canterbury Respiratory Research Group, Canterbury District Health Board, Christchurch, New Zealand.
Sci Rep. 2018 Sep 14;8(1):13829. doi: 10.1038/s41598-018-32162-2.
Low vitamin D status is associated with increased risk of pneumonia, greater disease severity and poorer outcome. However, no trials have examined the effect of adjunctive vitamin D therapy on outcomes in adults with community-acquired pneumonia (CAP). We conducted a randomised, double-blind, placebo-controlled trial examining the effects of adjunctive vitamin D in adults hospitalised with CAP. Participants were randomised to either a single oral dose of 200,000 IU vitamin D or placebo. The primary outcome was the complete resolution of chest radiograph infiltrate at 6 weeks post-study treatment. Secondary outcomes included length of hospital stay, intensive care admission and return to normal activity. Only participants who completed the study or died within the 6 week period were included in the analysis (n = 60 vitamin D, n = 57 placebo). Adjunctive vitamin D did not have any effect on the primary outcome (OR 0.78, 95% CI 0.31 to 1.86, p = 0.548). However, there was evidence it increased the complete resolution of pneumonia in participants with baseline vitamin D levels <25 nmol/L (OR 17.0, 95% CI 1.40-549.45, P = 0.043), but this did not reach statistical significance using exact methods (OR 13.0, 95%CI 0.7-960.4, P = 0.083). There were no significant effects for any secondary outcome.
维生素 D 水平低与肺炎风险增加、疾病严重程度增加和预后不良有关。然而,尚无试验研究过辅助维生素 D 治疗对社区获得性肺炎(CAP)成人患者结局的影响。我们进行了一项随机、双盲、安慰剂对照试验,以检验辅助维生素 D 在 CAP 住院成人中的疗效。参与者被随机分配至单次口服 20 万 IU 维生素 D 或安慰剂。主要结局是研究治疗后 6 周时胸部 X 线浸润完全消退。次要结局包括住院时间、入住重症监护病房和恢复正常活动。仅纳入完成研究或在 6 周内死亡的参与者进行分析(n=60 例维生素 D,n=57 例安慰剂)。辅助维生素 D 对主要结局没有任何影响(OR 0.78,95%CI 0.31-1.86,p=0.548)。然而,有证据表明,对于基线维生素 D 水平 <25nmol/L 的参与者,它增加了肺炎的完全消退(OR 17.0,95%CI 1.40-549.45,P=0.043),但使用确切方法未达到统计学意义(OR 13.0,95%CI 0.7-960.4,P=0.083)。任何次要结局均无显著影响。