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研究锌和维生素A治疗小儿社区获得性肺炎的疗效。

Investigating the Efficacy of Zinc and Vitamin A in Treating Pediatric Community-Acquired Pneumonia.

作者信息

Atta Aqsa, Aftab Ayesha, Shafqat Ayesha, Yousuf Muhammad Hamza, Ahmed Akbar, Pirzada Hannah, Khalid Humna, Hastings Natasha E

机构信息

Human Nutrition and Dietetics, Nishtar Medical University, Multan, PAK.

Pharmacology, Al Nafees Medical College and Hospital, Islamabad, PAK.

出版信息

Cureus. 2024 Jan 13;16(1):e52197. doi: 10.7759/cureus.52197. eCollection 2024 Jan.

Abstract

BACKGROUND

Community-acquired pneumonia (CAP) poses a significant global health challenge, even more so for children less than five years old. Nutritional interventions, such as zinc and vitamin A supplementation, are gaining attention for their therapeutic potential in enhancing recovery and minimizing pneumonia severity in pediatric patients.

OBJECTIVE

To assess the therapeutic benefits of zinc and vitamin A supplementation in pediatric CAP patients under five years old and to advocate for their use in clinical settings.

METHODOLOGY

Three groups were formed in a randomized controlled trial conducted from October 2022 to September 2023, to address zinc and vitamin A supplementation in pediatric patients under five years old in the intensive care unit with severe pneumonia. Group 1 received zinc supplementation, group 2 received vitamin A supplementation, and group 3 served as the control group, receiving antibiotic treatment exclusively for pneumonia. This treatment comprised either a β-lactam (amoxicillin-clavulanate, commonly referred to as Augmentin) administered orally at 500 mg/125 mg three times a day, Augmentin 875 mg/125 mg orally twice daily, or Augmentin 2000 mg/125 mg orally once daily. Additionally, the control group received a macrolide (azithromycin or clarithromycin) or doxycycline at a dosage of 100 mg orally twice daily.Linear regression analysis identified statistically significant decreases in both length of hospital stay and active pneumonic effusion.

RESULTS

The study encompassed 90 pediatric pneumonia patients with an age range of six to 55 months. Multiple linear regression analysis showed that both vitamin A and zinc led to a significant decrease in hospitalization length by 2.39 days (p < 0.01, 95% CI: 4.19-0.47) and 3.17 days (p < 0.01, 95% CI: 5.19-1.31), respectively. In comparison to the control group, both the vitamin A and zinc supplementation groups were linked to a shorter pneumonic effusion duration (p < 0.001).

CONCLUSION

Both interventions significantly reduced the duration of hospitalization (2.39 days for vitamin A and 3.17 days for zinc) and pneumonic effusion compared to the control group. These findings highlight the potential of zinc and vitamin A as valuable additions to standard CAP treatment regimens, potentially leading to improved clinical outcomes and reduced healthcare burdens.

摘要

背景

社区获得性肺炎(CAP)对全球公共卫生构成重大挑战,对于五岁以下儿童而言更是如此。营养干预措施,如补充锌和维生素A,因其在提高儿科患者康复率和降低肺炎严重程度方面的治疗潜力而受到关注。

目的

评估补充锌和维生素A对五岁以下儿科CAP患者的治疗益处,并提倡在临床环境中使用这些补充剂。

方法

在2022年10月至2023年9月进行的一项随机对照试验中,将患有重症肺炎的五岁以下儿科重症监护病房患者分为三组,以探讨锌和维生素A补充剂的作用。第一组接受锌补充剂,第二组接受维生素A补充剂,第三组作为对照组,仅接受针对肺炎的抗生素治疗。该治疗包括口服β-内酰胺类药物(阿莫西林-克拉维酸,通常称为奥格门汀),剂量为500毫克/125毫克,每日三次;或奥格门汀875毫克/125毫克,每日两次口服;或奥格门汀2000毫克/125毫克,每日一次口服。此外,对照组接受大环内酯类药物(阿奇霉素或克拉霉素)或强力霉素,剂量为100毫克,每日两次口服。线性回归分析显示,住院时间和活动性胸腔积液均有统计学意义的减少。

结果

该研究纳入了90名年龄在6至55个月之间的儿科肺炎患者。多元线性回归分析表明,维生素A和锌均使住院时间显著缩短,分别缩短了2.39天(p<0.01,95%置信区间:4.19-0.47)和3.17天(p<0.01,95%置信区间:5.19-1.31)。与对照组相比,维生素A和锌补充剂组的胸腔积液持续时间均较短(p<0.001)。

结论

与对照组相比,这两种干预措施均显著缩短了住院时间(维生素A为2.39天,锌为3.17天)和胸腔积液持续时间。这些发现凸显了锌和维生素A作为标准CAP治疗方案中宝贵补充剂的潜力,可能会改善临床结局并减轻医疗负担。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/512f/10859780/a753a3fe4c83/cureus-0016-00000052197-i01.jpg

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