背景:健康,均衡的饮食在呼吸系统疾病中起着至关重要的作用。由于微量营养素缺乏在慢性阻塞性肺疾病(COPD)患者中相对常见,补充微量营养素可能对这些患者产生有益的健康影响。本系统评价和荟萃分析旨在证明补充微量营养素对COPD患者肺功能的影响。
方法:PubMed,科克伦图书馆,和WebofScience数据库从其相应的创建中进行搜索,直到2024年2月。搜索词包括“慢性阻塞性肺疾病”,\'COPD\',\'微量营养素\',\'膳食补充剂\',\'维生素\',\'矿物\',和“随机对照试验”。进行了Meta分析,以评估单独或复合补充微量营养素对COPD患者肺功能的影响。
结果:共有43项RCT符合本研究的纳入标准。Meta分析显示,补充维生素D可以显着提高FEV1%(基线和干预后的WMDD差异(de):6.39,95%CI:4.59,8.18,p<0.01;干预后的WMDP指标(af):7.55,95%CI:5.86,9.24,p<0.01)和FEV1/FVC%(Wde:6.88,95CI:2.11,11.65%,W降低急性加重的几率,提高T细胞亚群水平,包括CD3+%,CD4+%,CD8+%,和CD4+/CD8+%(均p<0.01)。复合营养素干预可有效提高FEV1%(WMDde:8.38,95CI:1.89,14.87,WMDaf:7.07,95CI:-0.34,14.48)和FEV1/FVC%(WMDde:7.58,95%CI:4.86,10.29,WMDaf:6.00,95%CI:3.19,8.81)。然而,单独补充维生素C和维生素E对肺功能无显著影响(p>0.05)。
结论:补充微量营养素,例如单独的维生素D和复合营养素,对COPD患者的肺功能有改善作用。因此,适当补充微量营养素有利于COPD患者病情稳定和通气功能恢复.
BACKGROUND: A healthy, well-balanced diet plays an essential role in respiratory diseases. Since micronutrient deficiency is relatively common in patients with chronic obstructive pulmonary disease (COPD), micronutrient supplementation might have the beneficial health effects in those patients. This systematic
review and meta-analysis aimed to demonstrate the impact of micronutrient supplementation on the lung function of patients with COPD.
METHODS: The PubMed, Cochrane Library, and Web of Science databases were searched from their corresponding creation until February 2024. Search terms included \'chronic obstructive pulmonary disease\', \'COPD\', \'micronutrients\', \'dietary supplements\', \'vitamins\', \'minerals\', and \'randomized controlled trials\'. Meta-analysis was performed to evaluate the effects of micronutrient supplementation alone or complex on lung function in patients with COPD.
RESULTS: A total of 43 RCTs fulfilled the inclusion criteria of this study. Meta-analysis revealed that vitamin D supplementation could significantly improve FEV1% (WMDdifferences between baseline and post-intervention (de): 6.39, 95% CI: 4.59, 8.18, p < 0.01; WMDpost-intervention indicators (af): 7.55, 95% CI: 5.86, 9.24, p < 0.01) and FEV1/FVC% (WMDde: 6.88, 95%CI: 2.11, 11.65, WMDaf: 7.64, 95% CI: 3.18, 12.10, p < 0.001), decrease the odds of acute exacerbations, and improve the level of T-cell subsets, including CD3+%, CD4+%, CD8+%, and CD4+/CD8+% (all p < 0.01). The effects of compound nutrients intervention were effective in improving FEV1% (WMDde: 8.38, 95%CI: 1.89, 14.87, WMDaf: 7.07, 95%CI: -0.34, 14.48) and FEV1/FVC% (WMDde: 7.58, 95% CI: 4.86, 10.29, WMDaf: 6.00, 95% CI: 3.19, 8.81). However, vitamin C and vitamin E supplementation alone had no significant effects on lung function (p > 0.05).
CONCLUSIONS: Micronutrient supplementation, such as vitamin D alone and compound nutrients, has improved effect on the lung function of patients with COPD. Therefore, proper supplementation with micronutrients would be beneficial to stabilize the condition and restore ventilation function for COPD patients.