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维生素C对患有呼吸衰竭的重症病毒性肺炎患者的疗效。

The effectiveness of vitamin C for patients with severe viral pneumonia in respiratory failure.

作者信息

Lee Song-I, Lim Chae-Man, Koh Younsuck, Huh Jin-Won, Lee Jae Seung, Hong Sang-Bum

机构信息

Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.

Department of Pulmonary and Critical Care Medicine, Chungnam National University Hospital, Chungnam National University School of Medicine, Daejeon, Republic of Korea.

出版信息

J Thorac Dis. 2021 Feb;13(2):632-641. doi: 10.21037/jtd-20-1306.

Abstract

BACKGROUND

Vitamin C is a well-known antioxidant and essential cofactor for numerous biological reactions. Several studies reported that vitamin C can improve the symptoms and prognosis of patients with sepsis and respiratory infection. We aimed to examine the effect of vitamin C when used in viral pneumonia patients with severe respiratory failure.

METHODS

Total 201 patients with viral pneumonia were included, of them 35 patients used vitamin C. We performed a statistical analysis through a propensity score matching of the age and baseline characteristics of these patients.

RESULTS

There were differences between the vitamin C group and non-vitamin C group in terms of age (60±15 66±14, P=0.03), extracorporeal membrane oxygenation (28.6% 5.4%, P<0.001), and procalcitonin (3±8 9±23, P=0.02). The 28-day mortality was not different between the two groups (20.0% 24.7%, P=0.33). In the propensity-matched group, the 28-day mortality was not significantly different between the two groups (20.0% 37.1%, P=0.07). Moreover, no difference was observed in shock reversal within 14 days (45.7% 25.7%, P=0.08) and recovery after acute kidney injury (52.9% 66.7%, P=0.41) between the two groups. Vitamin C was not a prognostic factor for 28-day mortality (P=0.33).

CONCLUSIONS

In this study adjunctive intravenous vitamin C therapy alone was not associated with improvement of the 28-day mortality and prognosis in patients with severe viral pneumonia with respiratory failure.

摘要

背景

维生素C是一种众所周知的抗氧化剂,也是众多生物反应的必需辅助因子。多项研究报告称,维生素C可改善脓毒症和呼吸道感染患者的症状及预后。我们旨在研究维生素C用于重症呼吸衰竭的病毒性肺炎患者时的效果。

方法

共纳入201例病毒性肺炎患者,其中35例使用了维生素C。我们通过对这些患者的年龄和基线特征进行倾向评分匹配来进行统计分析。

结果

维生素C组和非维生素C组在年龄(60±15对66±14,P=0.03)、体外膜肺氧合(28.6%对5.4%,P<0.001)和降钙素原(3±8对9±23,P=0.02)方面存在差异。两组的28天死亡率无差异(20.0%对24.7%,P=0.33)。在倾向评分匹配组中,两组的28天死亡率无显著差异(20.0%对37.1%,P=0.07)。此外,两组在14天内休克逆转情况(45.7%对25.7%,P=0.08)和急性肾损伤后的恢复情况(52.9%对66.7%,P=0.41)方面未观察到差异。维生素C不是28天死亡率的预后因素(P=0.33)。

结论

在本研究中,单独使用静脉注射维生素C辅助治疗与重症呼吸衰竭的病毒性肺炎患者的28天死亡率改善及预后无关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6222/7947518/1b95b7173f92/jtd-13-02-632-f1.jpg

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