维生素D对呼吸系统相关病毒阳性者血清学指标及康复效果研究

Study on Serological Parameters and Recovery Outcomes of Vitamin D in Respiratory Viral Pneumonia Patients

摘要: 目的：本研究旨在探究维生素D对呼吸系统相关病毒肺炎(COVID-19)患者血清学及病原学指标、影像学变化等相关指标的影响，探索分析呼吸系统相关病毒肺炎的防治新思路。方法：本研究为病例对照研究，纳入2022年1月至2023年3月就诊于我市公共卫生中心及我院的呼吸系统相关病毒肺炎患者共300例，根据是否应用维生素D治疗分为标准治疗组(150例)和维生素D组(150例)。评估两种治疗方式的临床缓解情况及血清学、病原学、影像学改善情况。结果：1) 两组患者的性别、年龄及治疗前白细胞计数(WBC)、中性粒细胞计数(NEUT)、淋巴细胞计数(LYMF)、白细胞介素6 (IL-6)、C反应蛋白(CRP)、降钙素原(PCT)、25(OH)D、血钙水平差异无统计学意义(P > 0.05)，且两组患者的25(OH)D水平均明显低于正常参考值。2) 维生素D组治疗后25(OH)D水平明显升高，血钙水平亦升高；标准治疗组25(OH)D仅轻度升高、血钙水平则无差异。两组患者治疗后WBC、NEUT、IL-6、CRP、PCT降低，LYMF升高。比较两组患者治疗前后各指标变化发现，维生素D组LYMF、25(OH)D、血钙水平比标准治疗组升高趋势更为显著(P < 0.05)，IL-6、CRP水平下降更为明显(P < 0.05)；而WBC、NEUT、PCT变化差值较标准治疗组无明显差异(P > 0.05)。维生素D组的症状好转时间、核酸转阴时间均短于标准治疗组(P < 0.05)，且影像学改善更为显著(P < 0.05)。结论：在标准治疗的基础上补充维生素D可改善呼吸系统相关病毒肺炎患者的炎症指标，缩短COVID-19病程，减轻肺部炎症。

Abstract: Objective: This study aimed to investigate the effects of vitamin D on serological, etiological, and imaging indicators in patients with respiratory viral pneumonia, exploring new strategies for its prevention and treatment. Methods: This case-control study included 300 respiratory viral pneumonia patients admitted to the city’s public health center and our hospital between January 2022 and March 2023. Patients were divided into a standard treatment group (n = 150) and a vitamin D group (n = 150) based on whether they received vitamin D supplementation. Clinical remission, along with improvements in serological, etiological, and imaging parameters, was evaluated. Results: There were no significant differences (P > 0.05) in gender, age, or pre-treatment levels of white blood cell count (WBC), neutrophil count (NEUT), lymphocyte count (LYMF), interleukin-6 (IL-6), C-reactive protein (CRP), procalcitonin (PCT), 25-hydroxyvitamin D [25(OH)D], or serum calcium between the two groups. Notably, 25(OH)D levels in both groups were significantly lower than the normal reference range. In post-treatment, the vitamin D group showed significantly increased 25(OH)D and serum calcium levels, while the standard treatment group exhibited only a mild increase in 25(OH)D and no change in serum calcium. Both groups demonstrated decreased WBC, NEUT, IL-6, CRP, and PCT, and increased LYMF after treatment. Comparing the changes between groups revealed that the vitamin D group had significantly greater increases in LYMF, 25(OH)D, and serum calcium (P < 0.05), and significantly greater decreases in IL-6 and CRP (P < 0.05) than the standard treatment group. However, the changes in WBC, NEUT, and PCT did not differ significantly between groups (P > 0.05). Symptom resolution time and nucleic acid negative conversion time were significantly shorter in the vitamin D group compared to the standard treatment group (P < 0.05), and imaging improvement was also significantly more pronounced (P < 0.05). Conclusion: Supplementation with vitamin D, in addition to standard treatment, can improve inflammatory markers, shorten the clinical course, and reduce lung inflammation in respiratory viral pneumonia patients.