Morcos M M, Gabr A A, Samuel S, Kamel M, el Baz M, el Beshry M, Michail R R
National Research Centre, Dokki Cairo, Egypt.
Boll Chim Farm. 1998 May;137(5):157-64.
Our study was done to assess the value of administration of vitamin D to tuberculous children. The study included twenty four newly diagnosed tuberculous children; eleven males and thirteen females. Their age ranged from one and half to thirteen years. Thirteen patients were extra thoracic type of T.B., while only seven were intrathoracic and the rest were mixed. They were randomly divided into two Groups according to the treatment administered: Group A patients were given Rifampicin, Isoniazid and Streptomycin. Group B received in addition vitamin D. After eight weeks therapy, the patients of each group were evaluated regarding clinical, laboratory, and radiological improvement. Vitamin D level is raised after treatment in both Groups A and B, but this rise is not significant. It also showed insignificant difference between the two groups. Vitamin D level showed very high significant decrease in tuberculous children than matched healthy controls (non tuberculous children). Calcium was significantly elevated after treatment in Group A whereas no significant change was detected in Group B. Phosphorous was highly significantly elevated after treatment in Group A, whereas in Group B it is just significantly elevated. Alkaline phosphatase level in both groups A and B were slightly decreased after treatment. However, this decrease was not significant. Clinical improvement was more evident in Group B patients (those taking vitamin D) as compared to Group A patients. The same was noted with X-ray and Sonographic findings. We concluded that vitamin D therapy may be of great value in addition to antituberculous drugs in the treatment of tuberculous children, and its use is highly recommended.
我们开展这项研究是为了评估给患结核病儿童补充维生素D的价值。该研究纳入了24名新诊断出的患结核病儿童,其中11名男性,13名女性。他们的年龄在1.5岁至13岁之间。13例患者为胸外结核类型,仅7例为胸内结核,其余为混合型。根据所给予的治疗方法,他们被随机分为两组:A组患者接受利福平、异烟肼和链霉素治疗。B组除上述治疗外还补充维生素D。经过8周治疗后,对每组患者的临床、实验室和影像学改善情况进行评估。A组和B组治疗后维生素D水平均有所升高,但这种升高并不显著。两组之间也无显著差异。与匹配的健康对照(非患结核病儿童)相比,患结核病儿童的维生素D水平显著降低。A组治疗后钙水平显著升高,而B组未检测到显著变化。A组治疗后磷水平显著升高,而B组仅略有升高。A组和B组治疗后碱性磷酸酶水平均略有下降,但这种下降并不显著。与A组患者相比,B组患者(服用维生素D的患者)的临床改善更为明显。X线和超声检查结果也是如此。我们得出结论,在抗结核药物治疗患结核病儿童时,维生素D治疗可能具有很大价值,强烈建议使用。