哈密地区儿童肺结核采用维生素D辅助治疗的临床研究

Clinical study of vitamin D assisted treatment for children with pulmonary tuberculosis in Hami area

目的探讨哈密地区儿童肺结核采用维生素D辅助治疗的临床研究。方法回顾性分析本院2015年1月-2017年9月确诊的0~14岁肺结核患儿共136例,均给予抗结核治疗。根据患儿及其家属自愿选择的不同治疗方案分为68例的治疗组(常规抗结核+维生素D辅助治疗)和68例的对照组(常规抗结核治疗),两组均治疗12周。比较两组患儿治疗前后的临床各观察指标(血沉、血清钙、体温、体重、维生素D、辅助T细胞)的变化,两组患儿治疗后的临床症状和肺CT检查的测定结果,及治疗后维、汉族患儿间的临床各观察指标。结果治疗6周后,两组的辅助T细胞、维生素D、血清钙和血沉水平较治疗前均明显改善(P<0.05),其中治疗组变化更为明显(P<0.05);治疗12周后,两组的临床症状和肺CT测定结果比较,治疗组明显优于对照组(P<0.001);治疗6周后,维、汉族患儿之间临床各观察指标比较均无统计学差异(P>0.05)。结论维生素D可以作为哈密地区儿童肺结核的辅助药物应用,可明显改善患儿临床各观察指标及临床症状,对哈密维、汉族儿童肺结核均效果显著。

Objective To discuss the clinical study of vitamin D assisted treatment for children with pulmonary tuberculosis in Hami area.Methods 136 cases of 0~14 years old children with pulmonary tuberculosis diagnosed in hospital from January 2015 to September 2017 were reviewed,and all of them were given anti tuberculosis treatment.The patients were divided into the treatment group(routine anti-tuberculosis+vitamin D adjuvant therapy)and the control group(routine anti-tuberculosis therapy),68 cases in each group according to the different treatment options voluntarily chosen by themselves and their families.They were treated for 12 weeks.The changes of the clinical observation indexes(erythrocyte sedimentation,serum calcium,body temperature,weight,vitamin D,auxiliary T cells)between the two groups were observed before and after treatment.The clinical symptoms and lung CT examination of the two groups after treatment,and the clinical observation indexes of the Uygur people and the Han children after treatment were compared.Results 6 weeks after treatment,the levels of helper T cells,vitamin D,serum calcium and erythrocyte sedimentation rate in the two groups were significantly improved compared with those before treatment,and the above indexes in the observation group were significantly better than those in the control group(P<0.05).12 weeks after treatment,the clinical symptoms and lung CT results were significantly better in the treatment group than in the control group(P<0.001).6 weeks after treatment,there was no statistical difference in the clinical observation indexes between Uygur and Han children(P>0.05).Conclusion Vitamin D can be used as an auxiliary drug for children with pulmonary tuberculosis in Xinjiang area,which can significantly improve the clinical observation indexes and clinical symptoms of children,and has significant effects on children with pulmonary tuberculosis of Uygur and Han nationality in Hami area.