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补充骨化三醇对全身炎症反应阳性患者感染生物标志物的影响:一项随机对照试验。

Effect of calcitriol supplementation on infectious biomarkers in patients with positive systemic inflammatory response: A Randomized Controlled Trial.

作者信息

Sistanizad Mohammad, Salarian Sara, Kouchek Mehran, Shojaei Seyedpouzhia, Miri MirMohammad, Masbough Farnoosh

机构信息

Department of Clinical Pharmacy, School of Pharmacy.

Prevention of Cardiovascular Disease Research Center.

出版信息

Ann Med Surg (Lond). 2024 Jan 3;86(2):875-880. doi: 10.1097/MS9.0000000000001643. eCollection 2024 Feb.

DOI:10.1097/MS9.0000000000001643
PMID:38333320
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10849351/
Abstract

BACKGROUND

Sepsis is one of the common causes of hospitalization of patients in intensive care units. A significant role for vitamin D in sepsis has been proposed, which is due to its active metabolite, calcitriol.

AIMS

Evaluate the effect of calcitriol supplementation on infectious biomarkers, including procalcitonin and presepsin.

METHODS

Patients with sepsis were divided into intervention and control group. Patients in the intervention group received intravenous calcitriol daily for 3 days. The serum levels of procalcitonin and presepsin were evaluated on days 0, 3, and 5 after administration.

RESULTS

Fifty-two SIRS-positive patients were evaluated. Baseline characteristics, changes in Sequential Organ Failure Assessment (SOFA) score and blood levels of vitamin D were not significantly different between the two groups. Procalcitonin levels on day 5 and the differences between day 5 and 0 were significantly lower in the intervention group ( = 0.02). Presepsin on the third and fifth days in the intervention group was reduced, but in the control group, there was an ascending trend. However, there was no significant difference between the two groups on days 3 and 5 ( = 0.17 and = 0.06, respectively) or between days 3 as well as 5 and the baseline presepsin level ( = 0.93 and = 0.92, respectively). The ICU length of stay and 28-day mortality did not differ significantly either between the two arms of the study.

CONCLUSIONS

Finally, the results of this study showed that the administration of intravenous calcitriol could reduce the levels of procalcitonin but did not have a significant effect on presepsin.

摘要

背景

脓毒症是重症监护病房患者住院的常见原因之一。已有人提出维生素D在脓毒症中发挥重要作用,这归因于其活性代谢产物骨化三醇。

目的

评估补充骨化三醇对包括降钙素原和可溶性髓系细胞触发受体-1在内的感染生物标志物的影响。

方法

将脓毒症患者分为干预组和对照组。干预组患者每天静脉注射骨化三醇,共3天。在给药后第0、3和5天评估降钙素原和可溶性髓系细胞触发受体-1的血清水平。

结果

对52名全身炎症反应综合征阳性患者进行了评估。两组之间的基线特征、序贯器官衰竭评估(SOFA)评分变化和维生素D血水平无显著差异。干预组第5天的降钙素原水平以及第5天与第0天之间的差异显著更低(P = 0.02)。干预组第3天和第5天的可溶性髓系细胞触发受体-上升趋势。然而,两组在第3天和第5天之间(分别为P = 0.17和P = 0.06)或第3天和第5天与基线可溶性髓系细胞触发受体-1水平之间(分别为P = 0.93和P = 0.92)均无显著差异。研究的两组之间在重症监护病房住院时间和28天死亡率方面也无显著差异。

结论

最后,本研究结果表明静脉注射骨化三醇可降低降钙素原水平,但对可溶性髓系细胞触发受体-1没有显著影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a73a/10849351/de2481bd2ac6/ms9-86-0875-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a73a/10849351/08a5864ac6a7/ms9-86-0875-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a73a/10849351/4ec1d0a53d3c/ms9-86-0875-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a73a/10849351/de2481bd2ac6/ms9-86-0875-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a73a/10849351/08a5864ac6a7/ms9-86-0875-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a73a/10849351/4ec1d0a53d3c/ms9-86-0875-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a73a/10849351/de2481bd2ac6/ms9-86-0875-g003.jpg

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Effect of High-Dose Vitamin D on Duration of Mechanical Ventilation in ICU Patients.大剂量维生素D对重症监护病房患者机械通气持续时间的影响。
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Presepsin is an early monitoring biomarker for predicting clinical outcome in patients with sepsis.血清淀粉样蛋白前体是预测脓毒症患者临床结局的早期监测生物标志物。
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