肺结核患者血清微量元素对疾病发展与营养治疗影响的研究进展

doi:10.19982/j.issn.1000-6621.20240369

摘要/Abstract

摘要：

血清微量元素水平的变化与疾病的活动性、治疗效果及患者的营养状态密切相关,肺结核患者常常存在蛋白质-能量型营养不良及必需微量元素的缺乏。微量元素的缺乏与肺结核之间存在明显的双向因果关系,即营养不良可能加剧肺结核的病情,而肺结核的存在又可能导致微量元素的进一步缺乏。笔者结合国内外结核病与微量元素的研究现状,对微量元素作用于结核分枝杆菌的机制、微量元素在肺结核患者中对于疾病诊断、病情严重程度评估、抗结核疗效和微量元素补充在营养治疗等方面的研究进展进行综述,以期增强对肺结核患者微量元素相关营养问题的认识水平和重视程度。

关键词: 结核,肺, 微量营养系, 综述文献(主题)

Abstract:

Serum trace element concentrations are intrinsically linked to disease activity, treatment outcomes, and the nutritional status of patients. Pulmonary tuberculosis (PTB) patients frequently present with protein-energy malnutrition and deficiencies in essential micronutrients. A significant bidirectional relationship exists between micronutrient deficiencies and PTB: malnutrition can worsen the progression of PTB, while the disease itself further depletes micronutrient reserves. The author integrates current research on tuberculosis and trace elements, providing a comprehensive review of the mechanisms by which trace elements influence Mycobacterium tuberculosis. The review also examines the role of trace elements in diagnosing PTB, evaluating disease severity, enhancing the efficacy of anti-tuberculosis treatments, and their supplementation in nutritional therapy. This work aims to deepen understanding and raise awareness of trace element-related nutritional challenges in tuberculosis patients.

Key words: Tuberculosis,pulmonary, Micronutrients, Review literature as topic

中图分类号:

R52
R459.3

游成东, 朱玲, 李佩波. 肺结核患者血清微量元素对疾病发展与营养治疗影响的研究进展[J]. 中国防痨杂志, 2025, 47(2): 218-223. doi: 10.19982/j.issn.1000-6621.20240369

You Chengdong, Zhu Ling, Li Peibo. Research progress on serum trace elements in the development and nutritional support of pulmonary tuberculosis patients[J]. Chinese Journal of Antituberculosis, 2025, 47(2): 218-223. doi: 10.19982/j.issn.1000-6621.20240369

图/表 1

表1

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第一作者	年度	国家	对象	样本量	干预方案	对照组方案	随访时间	干预结果
Karyadi^[35]	2002	印度尼西亚	病原学阳性肺结核	110	每日视黄醇(1500IU)、维生素 A (5000IU)和硫酸锌(含锌15mg)	由乳糖组成安慰剂和抗结核药物	6个月	前2个月提高抗结核效果
Range^[36]	2005	坦桑尼亚	病原学阳性肺结核	499	每日锌片(45mg)	安慰剂片剂的颜色、形状和大小相同	2个月	痰培养阴转无影响,微量营养素补充剂可增加体质量
Pakasi^[37]	2010	印度尼西亚	病原学阳性肺结核	255	每日剂量锌(15mg)、维生素 A(5000IU)和组合剂量	安慰剂和抗结核药物	6个月	单独或联合补充锌和维生素 A不能缩短阴转时间
Lawson^[38]	2010	尼日利亚	病原学阳性肺结核	350	每周锌 (90mg)和每日剂量的维生素 A(5000IU)	安慰剂与抗结核药物	6个月	痰菌阴转和影像学改变无差异,谨慎补锌
Armijos^[39]	2010	墨西哥	病原学阳性肺结核	39	每日维生素 A(5000IU)和锌(50mg),持续 4 个月	安慰剂组受试者接受感官相同、匹配的安慰剂	6个月	补锌有助于痰菌阴转和改善免疫反应
Visser^[40]	2011	南非	病原学阳性肺结核	154	每日棕榈酸视黄酯 (200000IU) 和锌(15mg),持续 8 周	标准抗结核药物	2个月	痰菌转化、影像学、身高无差异,不影响2个月内的抗结核效果
Zolfaghari^[41]	2021	伊朗	病原学阳性肺结核	74	隔日1次补锌(50mg)	安慰剂和抗结核药物	6个月	前6周有利于痰菌阴转