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危重病性多发性神经病和肌病患者的血清维生素 D 水平。

Vitamin D serum level in subjects with critical illness polyneuropathy and myopathy.

机构信息

Unit of Neuro-rehabilitation, and Rehabilitation Medicine, IRCCS "Casa Sollievo della Sofferenza", San Giovanni Rotondo (FG), Italy.

Unit of Biostatistics, IRCCS "Casa Sollievo della Sofferenza", San Giovanni Rotondo, (FG), Italy.

出版信息

J Musculoskelet Neuronal Interact. 2020 Mar 3;20(1):18-26.

Abstract

BACKGROUND

Critical illness polyneuropathy and myopathy (CIPNM) is a disabling neuropathy that occurs in intensive care unit (ICU) subjects. It was hypothesized that a low serum level or deficiency of 25(OH)D might be associated with CIPNM. The aim of the present study was to ascertain the 25(OH)D serum level in subjects with CIPNM.

METHOD

Consecutive ICU patients admitted to neuro-rehabilitation were prospectively enrolled. At admission, vitamin D serum levels were measured and EMG examination was performed to ascertain those with CIPNM. 25(OH)D was stratified as sufficient (≥30 ng/mL) insufficient (20-29.9 ng/mL), and deficient (<20 ng/mL).

RESULTS

Eighty-four patients (31 F, 53 M; mean age 51.7±12.6) were identified and 63 (21 F, 42 M) enrolled. CIPNM was detected in 38 (9 F, 29 M) patients. A deficient mean serum level of vitamin D was observed in the whole population: 18.1 ± 9.2 ng/mL. No difference of vitamin D serum levels was detected in subjects with and without CIPNM: 17.5 ± 8.4 and 19.0 ± 10.5 ng/mL (p=0.58), respectively.

CONCLUSION

Almost all subjects showed Vitamin D deficiency. No difference was detected between those with and without CIPNM. The condition might represent a secondary phenomenon resulting from the inflammatory process as well as from conditions that could interfere with vitamin D metabolism.

摘要

背景

危重病性多发性神经病和肌病(CIPNM)是一种发生在重症监护病房(ICU)患者中的致残性神经病。有人假设,血清 25(OH)D 水平低或缺乏可能与 CIPNM 有关。本研究旨在确定 CIPNM 患者的血清 25(OH)D 水平。

方法

连续纳入入住神经康复病房的 ICU 患者。入院时,测量维生素 D 血清水平并进行肌电图检查以确定是否存在 CIPNM。25(OH)D 分为充足(≥30ng/ml)、不足(20-29.9ng/ml)和缺乏(<20ng/ml)。

结果

共确定 84 例患者(31 例女性,53 例男性;平均年龄 51.7±12.6 岁),其中 63 例(21 例女性,42 例男性)入选。38 例(9 例女性,29 例男性)患者发现 CIPNM。全人群维生素 D 血清水平普遍不足:18.1±9.2ng/ml。有和无 CIPNM 的患者维生素 D 血清水平无差异:17.5±8.4 和 19.0±10.5ng/ml(p=0.58)。

结论

几乎所有患者均存在维生素 D 缺乏。有和无 CIPNM 的患者之间未检测到差异。这种情况可能是炎症过程以及可能干扰维生素 D 代谢的情况引起的继发性现象。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9171/7104589/b0bc7d77e9d2/JMNI-20-018-g001.jpg

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