Zhang Li, Wang Shanshan, Zhu Yuyin, Yang Tianchi
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.
Neuropsychiatr Dis Treat. 2018 Nov 14;14:3103-3109. doi: 10.2147/NDT.S183039. eCollection 2018.
We aimed to evaluate whether high-dose cholecalciferol has beneficial effects on depression in pulmonary tuberculosis (PTB) patients.
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.
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.
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.
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。
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。
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。
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。