本文選題：肺結(jié)核　切入點：營養(yǎng)狀況　出處：《青島大學(xué)》2013年碩士論文　論文類型：學(xué)位論文

【摘要】：目的：通過檢測肺結(jié)核患者的血清維生素A、D水平,了解肺結(jié)核患者維生素A、D的營養(yǎng)狀況,同時結(jié)合抑菌試驗了解維生素A、D的體外抑菌效果。方法：選取152例肺結(jié)核患者作為病例組,選擇同一地區(qū)的218例健康人群作為對照組,采用問卷調(diào)查的方法收集研究對象的一般資料包括年齡、性別、身高、體重等；分別采用高效液相色譜法和液相色譜-串聯(lián)質(zhì)譜法來檢測血清維生素A、D水平。另選取118例痰培養(yǎng)結(jié)果為陽性的結(jié)核病患者,從痰液中分離并培養(yǎng)出陽性菌株,進(jìn)行維生素A、D干預(yù)實驗。結(jié)果：病例組血清維生素A和D的水平分別為173μg/ml和15.05ng/ml,均低于對照組的1.93μg/ml和17.00ng/ml,其中兩組間維生素A水平差異無統(tǒng)計學(xué)意義,維生素D差異有統(tǒng)計學(xué)意義；血清維生素A、D水平與研究對象的年齡、性別及BMI值無明顯相關(guān)關(guān)系；病例組維生素A的缺乏比例為3.29%,高于對照組的2.75%,但差異無統(tǒng)計學(xué)意義；病例組中維生素D的嚴(yán)重缺乏比例為38.16%,顯著高于對照組的21.56%(P0.05),不足和充足的比例在兩組間無明顯差異。體外抑菌試驗結(jié)果表明,與對照組相比,添加500IU/mL (VA1、1000IU/mL (VA2)和2000IU/mL (VA3)維生素A的各劑量組培養(yǎng)基上的結(jié)核桿菌生長都受到不同程度的抑制,菌落生長結(jié)果為陽性所占的比例分別為92.37%、81.36%和86.44%,均低于對照組的100%(P0.05)；而添加25IU/mL (VDl)、50IU/mL (VD2)、75IU/mL (VD3)和100IU/mL (VD4)維生素D的各劑量組菌落生長結(jié)果為陽性所占比例分別為94.07%、93.22%、94.92%和91.53%,與對照組相比有統(tǒng)計學(xué)差異(P0.05)；隨著VA劑量的增加,VA2組培養(yǎng)結(jié)果為陰性的比例18.64%高于VA1組的7.63%,抑菌效果有所提高(P0.0167),而VA3組與VA2組相比,抑菌效果增加不明顯(P0.0167)；維生素D各劑量組相比,抑菌效果無明顯差異(P0.05)；維生素A與維生素D的抑菌效果相比,VA2組及VA3組的抑菌效果優(yōu)于維生素D組(P0.05)。結(jié)論：肺結(jié)核患者的血清維生素A水平與正常對照相比無統(tǒng)計學(xué)差異,維生素D水平低于正常對照組,兩組人群中維生素A的營養(yǎng)狀況較好,維生素D的缺乏比例普遍較高,尤其是肺結(jié)核患者更易缺乏維生素D；適宜劑量的維生素A、D能在體外抑制結(jié)核桿菌的生長。
[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.
【學(xué)位授予單位】：青島大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2013
【分類號】：R153.9;R521

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