Hunt C, Chakravorty N K, Annan G
Int J Vitam Nutr Res. 1984;54(1):65-74.
A double-blind placebo trial has been undertaken on 199 elderly patients admitted to an "acute" geriatric assessment ward. Clinical and biochemical assessment was made on admission (0) and at 2, 4, 8, 16 and 24 weeks (after admission). Ninety-four patients were supplemented with vitamin C (200 mg per day) and 105 had placebo tablets. Biochemical assessment included estimations of plasma and leucocyte (buffy layer) vitamin C, plasma folate, vitamin B12, cortisol and total white cell count. Plasma and leucocyte vitamin C levels remained low for several weeks in a substantial proportion of the non-supplemented patients, whereas low levels were virtually eliminated in the supplemented group. The results from this study suggest that the leucocyte vitamin C levels may give some indication of prognosis in this category of patients (ie. "acute" geriatric admissions) as evidenced by: i) the significantly higher mortality rate during the trial period of patients who started with low initial leucocyte vitamin C levels compared with those starting with higher levels, despite similar mean initial "severity of illness scores" between the two groups. ii) the marked trend, amongst placebo subjects, for those commencing the study with higher leucocyte vitamin C levels to fare better, in terms of progression to "well", than those starting with low levels. Amongst subjects starting with low leucocyte vitamin C levels, there was a trend for "vitamin C" subjects to have fared better by 8 weeks than "placebo" subjects. This again occurred despite similar mean initial "severity scores" between the two groups. Amongst subjects diagnosed with respiratory infections there was some tendency for supplemented patients to fare better than unsupplemented patients. Low leucocyte vitamin C levels, on admission, appear to be predictive of poor subsequent prognosis in elderly hospitalised patients. Results from this trial suggest that supplementation with a moderate dose of vitamin C may improve this prognosis and larger trials with greater numbers appear to be merited to confirm or deny this hypothesis.
对入住“急性”老年评估病房的199名老年患者进行了一项双盲安慰剂试验。在入院时（0周）以及入院后2、4、8、16和24周进行了临床和生化评估。94名患者补充了维生素C（每天200毫克），105名患者服用安慰剂片。生化评估包括血浆和白细胞（血沉棕黄层）维生素C、血浆叶酸、维生素B12、皮质醇和白细胞总数的测定。在相当一部分未补充维生素C的患者中，血浆和白细胞维生素C水平在数周内一直较低，而在补充组中，低水平几乎消除。这项研究的结果表明，白细胞维生素C水平可能为这类患者（即“急性”老年入院患者）的预后提供一些指示，证据如下：i）在试验期间，初始白细胞维生素C水平较低的患者的死亡率显著高于初始水平较高的患者，尽管两组的平均初始“疾病严重程度评分”相似。ii）在安慰剂受试者中，初始白细胞维生素C水平较高的受试者在进展到 “康复” 方面比初始水平较低的受试者有明显更好的趋势。在初始白细胞维生素C水平较低的受试者中，“维生素C” 组受试者在8周时的情况比 “安慰剂” 组受试者有更好的趋势。尽管两组的平均初始“严重程度评分”相似，但这种情况再次出现。在被诊断为呼吸道感染的受试者中，补充维生素C的患者有比未补充患者情况更好的趋势。入院时白细胞维生素C水平低似乎预示着老年住院患者随后的预后不良。该试验的结果表明，补充中等剂量的维生素C可能会改善这种预后，似乎值得进行更大规模、更多人数的试验来证实或否定这一假设。
