补充维生素D3对老年慢阻肺合并维生素D缺乏或不足者营养指标及体液免疫功能的影响

Effects of vitamin D3 supplementation on nutritional indexes and immune functions in elderly COPD patients with vitamin D deficiency or insufficiency

目的探讨老年慢性阻塞性肺疾病(慢阻肺)合并维生素D缺乏或不足患者经补充维生素D3后对其营养指标、体液免疫功能及慢阻肺疾病评估(CAT)评分的影响。方法选择老年慢阻肺合并维生素D充足40例为对照组,合并维生素D缺乏或不足的102例为实验组,不足及缺乏者分别补充维生素D30.5μg/d及0.25μg/d连续6个月。比较实验组干预前后及对照组25(OH)D、血常规、肝功能、免疫球蛋白指标及CAT评分。结果实验组干预前后及对照组三者间25(OH)D水平、LYM%、PA、IgG、CAT评分比较均有统计学意义(P<0.05或0.01)。实验组干预后的25(OH)D、LYM%、Alb、PA、IgG均较干预前增加、CAT评分下降(P<0.05或0.01)。实验组干预前与对照组25(OH)D、血常规、肝功能、免疫球蛋白指标及CAT评分等比较均有统计学意义(P<0.05或0.01);实验组干预后25(OH)D、LYM%、PA、IgA较对照组明显降低(P<0.05)。实验组25(OH)D水平与LYM%、Alb、PA、IgA、IgG及CAT评分呈明显正相关(r值分别为0.283、0.297、0.435、0.321、0.383、0.413,P<0.05或0.01)。结论老年慢阻肺合并维生素D缺乏或不足者25(OH)D存在较低的营养状态及体液免疫功能,维生素D3辅助治疗可在一定程度上改善患者的营养状态、体液免疫功能及CAT评分。

Objective To investigate the effects of vitamin D3 supplementation on nutritional indexes,immune functions and COPD assessment test(CAT)scores on elderly patients with chronic obstructive pulmonary disease(COPD)complicated with vitamin D deficiency or insufficiency.Methods 40 elderly patients with COPD complicated with sufficient vitamin D were selected as control group,and 102 patients complicated with vitamin D deficiency or insufficiency were selected as experimental group.The experimental group were respectively supplemented with 0.5μg/d and 0.25μg/d of vitamin D3 for 6 consecutive months.And then,25(OH)D levels,blood routines,liver functions,immunoglobulin indexes and CAT scores were compared between the experimental group before and after treatment and the control group.Results The comparison of 25(OH)D levels,lymphocyte ratio(LYM%),prealbumin(PA),IgG and CAT scores among the experimental group before and after intervention and the control group was statistically significant differences(P<0.05 or 0.01).Compared with those before intervention,the 25(OH)D level,LYM%,Alb,PA and IgG in the experimental group increased,while the CAT score decreased after intervention(P<0.05 or 0.01).The comparison of 25(OH)D levels,blood routines,liver functions,immunoglobulin indexes and CAT scores between the experimental group and control group before intervention was statistically significant(P<0.05 or 0.01).After intervention,the 25(OH)D level,LYM%,PA and IgA in the experimental group were significantly lower than those in the control group(P<0.05).The 25(OH)D level in the experimental group was significantly positively correlated with LYM%,Alb,PA,IgA,IgG and CAT score(r values were 0.283,0.297,0.435,0.321,0.383 and 0.413,respectively,P<0.05 or 0.01).Conclusion Elderly COPD patients complicated with vitamin D deficiency or deficiency have lower nutritional status and humoral immune function.Vitamin D3 adjuvant therapy can improve their nutritional status,humoral immune function and CAT score to some extent.