Objective: To systematically evaluate the efficacy and safety of vitamin D supplementation in the treatment of pulmonary tuberculosis. Methods: Biomedical Database was searched to collect randomized controlled trials (RCT) related to vitamin D supplementation in tuberculosis patients, and the retrieval time was from establishment to November 2019. Two evaluators independently screened the literature and extracted the data. The negative conversion rate of acid-fast-bacilli of sputum smear, the negative conversion rate of mycobacterium tuberculosis culture and the change of serum vitamin D level were the main outcome indicators, and the body mass index was the secondary outcome indicator. The incidence of hypercalcemia and abnormal urinary calcium were used as adverse event indicators and the RevMan 5.2 software was used for meta-analysis. Results: A total of 8 RCT(S) met the inclusion criteria, including 850 patients with tuberculosis. Meta-analysis showed that compared with the control group, negative conversion rate of acid-fast-bacilli of sputum smear and serum vitamin D level increased after 8 weeks of vitamin D supplementation [RR (95%CI) and mean deviation (MD) (95%CI) were 1.06 (1.00, 1.13) and 8.81 (1.81, 15.81), respectively; negative conversion rate of acid-fast-bacilli of sputum smear was not increased at week 4 and 12 [RR (95%CI) were 1.08 (0.97, 1.20) and 1.01 (0.91, 1.12), respectively]; negative conversion rate of mycobacterium tuberculosis culture in sputum was not increased after 4 and 8 weeks [RR (95%CI) were 1.06 (0.91, 1.22) and 1.02 (0.96, 1.08), respectively]; there was no change in body mass index [MD (95%CI):-0.02 (-0.53, 0.50)]; there was increased risk of abnormal urinary calcium [RR (95%CI): 2.45 (1.75, 3.41)], while no increase in risk of hypercalcemia [RR (95%CI): 1.99 (0.96, 4.13)]. Conclusion: Vitamin D supplementation is safe but not effective in the treatment of pulmonary tuberculosis.
目的： 系统评价补充维生素D辅助治疗肺结核的效果和安全性。 方法： 检索PubMed、The Cochrane Library、Web of Science、中国知网、万方和中国生物医学数据库，搜集肺结核患者补充维生素D辅助治疗相关的随机对照试验（RCT），检索时限均为从建库到2019年11月。由2名评价员独立筛选文献、提取资料，以痰抗酸杆菌涂片阴转率、痰结核分枝杆菌结核菌培养阴转率和血清Vit D水平变化情况为主要结局指标，以体质指数为次要结局指标；以高钙血症发生率和尿钙异常发生率为不良事件指标，采用RevMan 5.2软件进行荟萃分析。 结果： 共8个RCT符合纳入标准，包含850例肺结核患者，与对照组相比，补充维生素D 8周痰抗酸杆菌涂片阴转率和血清维生素D水平均上升[RR（95%CI）和均数差（95%CI）分别为1.06（1.00，1.13）和8.81（1.81，15.81）]；4和12周痰抗酸杆菌涂片阴转率未升高[RR（95%CI）分别为1.08（0.97，1.20）和1.01（0.91，1.12）]；4和8周痰结核分枝杆菌培养阴转率未升高[RR（95%CI）分别为1.06（0.91，1.22）和1.02（0.96，1.08）]；体质指数变化无统计学意义[均数差（95%CI）：-0.02（-0.53，0.50）]；尿钙异常发生风险上升[RR（95%CI）：2.45（1.75，3.41）]，高钙血症发生风险未上升[RR（95%CI）：1.99（0.96，4.13）]。 结论： 补充维生素D辅助治疗肺结核安全但无确切效果。.
Keywords: Meta-analysis; Safety; Treatment outcome; Tuberculosis, pulmonary; Vitamin D.