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维生素D3作为辅助治疗手段用于结核病患者抑郁症治疗的短期初步随机双盲对照研究。

Vitamin D3 as adjunctive therapy in the treatment of depression in tuberculosis patients: a short-term pilot randomized double-blind controlled study.

作者信息

Zhang Li, Wang Shanshan, Zhu Yuyin, Yang Tianchi

机构信息

Second Department of Pulmonary Medicine, Ningbo No 2 Hospital, Ningbo, Zhejiang, People's Republic of China.

Department of Psychology, Ningbo No 2 Hospital, Ningbo, Zhejiang, People's Republic of China.

出版信息

Neuropsychiatr Dis Treat. 2018 Nov 14;14:3103-3109. doi: 10.2147/NDT.S183039. eCollection 2018.

Abstract

OBJECTIVE

We aimed to evaluate whether high-dose cholecalciferol has beneficial effects on depression in pulmonary tuberculosis (PTB) patients.

METHODS

This pilot, randomized, and double-blind trial enrolled 123 recurrent PTB patients (aged ≥18 years) meeting criteria of major depressive disorder from four hospitals in Southeast China. Patients were randomly assigned to 8-week oral treatment with 100,000 IU/week cholecalciferol (Vit D group) or a matching placebo (control group). The primary outcome was treatment response, defined as a 50% reduction in symptoms and change in scores of the Chinese version of Beck Depression Inventory (BDI) from baseline to 8 weeks. Relative risks of depression were estimated using multivariable logistic regression.

RESULTS

Finally, 120 patients were enrolled, including 56 test patients and 64 controls. After 8 weeks, the treatment response or BDI scores did not differ significantly between groups. Multivariate logistic regression showed that BDI scores were not significantly improved in the Vit D group after adjustment for age, time to first negative smear, or 25-hydroxyvitamin D level.

CONCLUSION

The use of high-dose Vit D3 supplementation may not be warranted for reducing depressive symptoms in the PTB population. Nevertheless, this finding should be validated by further large-scale studies according to different kinds of depression or Vit D receptor polymorphism genotype.

摘要

目的

我们旨在评估高剂量胆钙化醇对肺结核(PTB)患者抑郁是否具有有益作用。

方法

这项前瞻性、随机、双盲试验纳入了来自中国东南部四家医院的123例符合重度抑郁症标准的复发性PTB患者(年龄≥18岁)。患者被随机分配接受为期8周的口服治疗,其中一组为每周100,000国际单位胆钙化醇(维生素D组),另一组为匹配的安慰剂(对照组)。主要结局是治疗反应,定义为症状减轻50%以及中文版贝克抑郁量表(BDI)评分从基线到8周的变化。使用多变量逻辑回归估计抑郁的相对风险。

结果

最终,120例患者入组,包括56例试验患者和64例对照。8周后,两组之间的治疗反应或BDI评分无显著差异。多变量逻辑回归显示,在调整年龄、首次痰涂片转阴时间或25-羟基维生素D水平后,维生素D组的BDI评分没有显著改善。

结论

对于减轻PTB人群的抑郁症状,可能无需使用高剂量维生素D3补充剂。然而,这一发现应根据不同类型的抑郁症或维生素D受体多态性基因型通过进一步的大规模研究加以验证。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0a4d/6241718/22466f6fad3d/ndt-14-3103Fig1.jpg

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