补充维生素 A、D 对2型糖尿病合并肺结核患者的影响

Effect of vitamin A and vitamin D supplement on diabetes and tuberculosis patients

目的：观察口服维生素 A、D 能否有效地改善2型糖尿病合并肺结核患者的预后。分析补充维生素A、D 对2型糖尿病合并肺结核患者的细胞免疫功能的影响。方法将58例被明确诊断同时患有2型糖尿病及肺结核的患者随机分为维生素 A（VA）干预组，维生素 D（VD）干预组，维生素 A ＋维生素 D（联合）干预组和空白对照组。在给予正常规范治疗同时，额外对 VA 干预组医嘱口服 VA，对 VD 干预组給予单药 VD 口服，对联合干预组同时给予维生素 A ＋维生素 D 口服，而对照组并不口服任何维生素类药物。观察患者入组后给予降糖治疗联合抗结核化疗后的血糖水平和抗酸杆菌转阴率。观察四组患者入组时及治疗后的 CD4＋/ CD8＋水平。结果 VA 组、VD组及联合组的抗酸杆菌转阴率明显高于对照组（P ﹤0.05）。但联合应用维生素 A、D 对肺结核转阴率的影响无明显差异。单独或联合应用维生素 A、D 对降低空腹血糖水平均无显著疗效。相对于对照组及单药组，联合应用维生素 A、D 对 CD4＋/ CD8＋水平提升作用更明显（P ﹤0.05）。结论单独或联合应用维生素 A、D 均可改善2型糖尿病合并肺结核患者的预后，提高患者免疫功能状态。

Objective To observe the effect of oral vitamin A and vitamin D on improvement of the prognosis of type 2 diabetes and tuberculosis patients,and analyze the effect of vitamin A and vitamin D on immune cell function in type 2 diabetic patients of pulmonary tuberculosis. Methods Fifty-eight patients were diagnosed with type 2 diabetes and simultaneously tuberculosis patients were randomly di-vided into vitamin（VA）intervention group,vitamin D（VD）intervention group,vitamin A ＋ vitamin D （combined）intervention group,and control group. One the basis of normal standard treatment,addition-al oral VA was given in VA intervention group,additional VD was given,in joint intervention group,oral vitamin A ＋ vitamin D was given,while in the control group,no vitamin oral drugs were given. After giv-ing hypoglycemic therapy combined with anti-TB drugs,the blood glucose levels and acid-fast bacilli neg-ative rates after chemotherapy were observed. The CD4 ＋ / CD8 ＋ levels after treatment were observed. Results AFB negative rates of VA group,VD group and the combination group were significantly higher than those in control group（P ﹤ 0. 05）. But there was no significant difference in combination of vitamins A,D on tuberculosis negative rate. Alone or in combination with vitamin A,D had no significant effect on reducing fasting blood glucose levels. Compared with the control group and the monotherapy group, the combination of vitamin A and vitamin enhanced the CD4 ＋ / CD8 ＋ levels（P ﹤ 0. 05）. Conclusions Alone or in combination with vitamin A and vitamin D can improve the prognosis of patients with diabetes mellitus type 2 and TB and improve the patients’immune state.