危重症外科患者维生素 D 缺乏的影响。
Effects of vitamin D deficiency in critically ill surgical patients.
机构信息
Department of Surgery, Wayne State University, School of Medicine, Detroit, MI, USA.
出版信息
Am J Surg. 2012 Mar;203(3):379-82; discussion 382. doi: 10.1016/j.amjsurg.2011.09.012. Epub 2011 Dec 28.
BACKGROUND
The incidence of vitamin D deficiency in critically ill patients is reported to be up to 50%, with a 3-fold increase in predicted mortality, but limited data exist concerning vitamin D deficiency in critically ill surgical patients.
METHODS
Sixty-six adult surgical intensive care unit patients who had 25-hydroxyvitamin D serum levels evaluated from January 2010 to February 2011 were prospectively identified. Patients were divided into groups according to vitamin D level (<20 vs ≥20 ng/mL).
RESULTS
Of the 66 patients evaluated, 49 (74%) had vitamin D levels < 20 ng/mL, and 17 (26%) had vitamin D levels ≥ 20 ng/mL. Patients with vitamin D levels < 20 versus ≥ 20 ng/mL had longer lengths of hospital stay. Lengths of intensive care unit stay were clinically longer, although not significant. Infection rates tended to be higher (P = .09), and a higher incidence of sepsis was seen in the patients with vitamin D levels < 20 ng/mL.
CONCLUSIONS
Vitamin D levels < 20 ng/mL have a significant impact on length of stay, organ dysfunction, and infection rates. More data are needed on the value of supplementation to improve these outcomes.
背景
危重症患者维生素 D 缺乏的发生率据报道高达 50%，其死亡率预计增加 3 倍，但关于危重症外科患者维生素 D 缺乏的数据有限。
方法
2010 年 1 月至 2011 年 2 月，前瞻性地确定了 66 例接受 25-羟维生素 D 血清水平评估的成年外科重症监护病房患者。根据维生素 D 水平（<20ng/ml 与≥20ng/ml）将患者分为两组。
结果
在评估的 66 例患者中，49 例（74%）维生素 D 水平<20ng/ml，17 例（26%）维生素 D 水平≥20ng/ml。维生素 D 水平<20ng/ml 与≥20ng/ml 的患者住院时间较长。尽管没有显著差异，但重症监护病房的住院时间也较长。感染率有升高趋势（P=0.09），维生素 D 水平<20ng/ml 的患者发生脓毒症的发生率更高。
结论
维生素 D 水平<20ng/ml 对住院时间、器官功能障碍和感染率有显著影响。需要更多的数据来评估补充维生素 D 对改善这些结局的价值。
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