肺结核患者维生素A、D营养状况及体外抑菌效果分析

发布时间：2018-03-18 00:02

本文选题：肺结核　切入点：营养状况　出处：《青岛大学》2013年硕士论文　论文类型：学位论文

【摘要】：目的：通过检测肺结核患者的血清维生素A、D水平,了解肺结核患者维生素A、D的营养状况,同时结合抑菌试验了解维生素A、D的体外抑菌效果。方法：选取152例肺结核患者作为病例组,选择同一地区的218例健康人群作为对照组,采用问卷调查的方法收集研究对象的一般资料包括年龄、性别、身高、体重等；分别采用高效液相色谱法和液相色谱-串联质谱法来检测血清维生素A、D水平。另选取118例痰培养结果为阳性的结核病患者,从痰液中分离并培养出阳性菌株,进行维生素A、D干预实验。结果：病例组血清维生素A和D的水平分别为173μg/ml和15.05ng/ml,均低于对照组的1.93μg/ml和17.00ng/ml,其中两组间维生素A水平差异无统计学意义,维生素D差异有统计学意义；血清维生素A、D水平与研究对象的年龄、性别及BMI值无明显相关关系；病例组维生素A的缺乏比例为3.29%,高于对照组的2.75%,但差异无统计学意义；病例组中维生素D的严重缺乏比例为38.16%,显著高于对照组的21.56%(P0.05),不足和充足的比例在两组间无明显差异。体外抑菌试验结果表明,与对照组相比,添加500IU/mL (VA1、1000IU/mL (VA2)和2000IU/mL (VA3)维生素A的各剂量组培养基上的结核杆菌生长都受到不同程度的抑制,菌落生长结果为阳性所占的比例分别为92.37%、81.36%和86.44%,均低于对照组的100%(P0.05)；而添加25IU/mL (VDl)、50IU/mL (VD2)、75IU/mL (VD3)和100IU/mL (VD4)维生素D的各剂量组菌落生长结果为阳性所占比例分别为94.07%、93.22%、94.92%和91.53%,与对照组相比有统计学差异(P0.05)；随着VA剂量的增加,VA2组培养结果为阴性的比例18.64%高于VA1组的7.63%,抑菌效果有所提高(P0.0167),而VA3组与VA2组相比,抑菌效果增加不明显(P0.0167)；维生素D各剂量组相比,抑菌效果无明显差异(P0.05)；维生素A与维生素D的抑菌效果相比,VA2组及VA3组的抑菌效果优于维生素D组(P0.05)。结论：肺结核患者的血清维生素A水平与正常对照相比无统计学差异,维生素D水平低于正常对照组,两组人群中维生素A的营养状况较好,维生素D的缺乏比例普遍较高,尤其是肺结核患者更易缺乏维生素D；适宜剂量的维生素A、D能在体外抑制结核杆菌的生长。
[Abstract]:Objective: to investigate the nutritional status of vitamin A D in pulmonary tuberculosis patients by detecting the serum vitamin A D level. Methods: 152 patients with pulmonary tuberculosis were selected as the case group and 218 healthy people from the same area as the control group. The general data including age, sex, height, weight and so on were collected by questionnaire. High performance liquid chromatography (HPLC) and liquid chromatography-tandem mass spectrometry (LC-MS) were used to detect serum vitamin A / D level. 118 patients with tuberculosis whose sputum culture results were positive were selected and positive strains were isolated and cultured from sputum. Results: the serum vitamin A and D levels in the case group were 173 渭 g / ml and 15.05 ng / ml, respectively, which were lower than those in the control group (1.93 渭 g / ml and 17.00 ng / ml). There was no significant correlation between serum vitamin A D level and age, sex and BMI value of the subjects, the ratio of vitamin A deficiency in the case group was 3.29, which was higher than that in the control group, but the difference was not statistically significant. The proportion of serious deficiency of vitamin D in the case group was 38.16, which was significantly higher than that in the control group (21.56%, P 0.05). There was no significant difference between the two groups in the proportion of deficiency and adequacy. The results of in vitro bacteriostasis test showed that, compared with the control group, there was no significant difference between the two groups. The growth of Mycobacterium tuberculosis was inhibited to varying degrees in the medium supplemented with vitamin A of 500 IUP / mL VA1 / 1000 IUP / mL VA2 and 2000 IUP / mL VA3), and the growth of Mycobacterium tuberculosis was inhibited in different degrees. The positive rate of colony growth was 92.373.36% and 86.44%, respectively, which was lower than that of the control group (100%, P 0.05), while the proportion of positive colony growth of vitamin D supplemented with 25 IUU / mL VDlC50 and 75 IUD / mL VD3 and 100 IUD / mL VD4 was 94.07% 93.229.92% and 91.53%, respectively, and that of the control group was 94.07% and 91.53%, respectively. With the increase of VA dose, the ratio of negative culture results in group A 2 was 18.64% higher than that in group VA1, and the bacteriostatic effect was improved (P 0.0167%), while that in group VA3 was higher than that in group VA2. The bacteriostatic effect was not significantly increased (P 0.0167). The bacteriostatic effect of vitamin A and vitamin D was higher than that of vitamin D group and vitamin A group. Conclusion: there was no significant difference in serum vitamin A level between pulmonary tuberculosis patients and normal control group, and the bacteriostatic effect of VA2 group and VA3 group was better than that of vitamin D group. The level of vitamin D was lower than that of the normal control group. The nutritional status of vitamin A in the two groups was better, and the proportion of vitamin D deficiency was generally higher. In particular, TB patients are more prone to vitamin D deficiency, and the appropriate dose of vitamin A D can inhibit the growth of Mycobacterium tuberculosis in vitro.
【学位授予单位】：青岛大学
【学位级别】：硕士
【学位授予年份】：2013
【分类号】：R153.9;R521

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