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中华重症医学电子杂志 ›› 2022, Vol. 08 ›› Issue (04) : 333 -339. doi: 10.3877/cma.j.issn.2096-1537.2022.04.010

专题笔谈

维生素D在重症患者中的应用—进展与困境
刘艾然1,()   
  1. 1. 210009 南京,江苏省重症医学重点实验室 东南大学附属中大医院重症医学科
  • 收稿日期:2022-11-02 出版日期:2022-11-28
  • 通信作者: 刘艾然

Vitamin D in critically ill patients: progress and dilemma

Airan Liu1,()   

  1. 1. Department of Critical Care Medicine, Jiangsu Provincial Key Laboratory of Critical Care Medicine, Zhongda Hospital, School of Medicine, Southeast University, Nanjing 210009, China
  • Received:2022-11-02 Published:2022-11-28
  • Corresponding author: Airan Liu
引用本文:

刘艾然. 维生素D在重症患者中的应用—进展与困境[J]. 中华重症医学电子杂志, 2022, 08(04): 333-339.

Airan Liu. Vitamin D in critically ill patients: progress and dilemma[J]. Chinese Journal of Critical Care & Intensive Care Medicine(Electronic Edition), 2022, 08(04): 333-339.

维生素D是维系生命活动的一种重要脂溶性维生素,具有多种生物学效应和生理、病理意义,其在重症患者中的监测和治疗价值也获得了越来越多的关注。重症患者由于维生素D摄入减少、代谢改变、清除增多及血液稀释等因素的影响,维生素D水平低下广泛存在,且与重症患者预后不良具有一定的相关性。很多研究开始探索补充维生素D在重症患者中的治疗作用和价值。不同的研究在纳入人群、研究方法和研究结果上存在较大的异质性。重症患者补充维生素D是否有助于改善临床结局还存在争议。维生素D治疗的目标适应人群、监测评估的方法和标准、制剂和剂量、补充时机等均可能影响维生素D的疗效评估。进一步加强中国重症患者维生素D水平的监测,开展特定人群维生素D的补充对临床结局影响的研究是有意义的。本文主要探讨维生素D在重症疾病治疗中的应用价值与应用前景。

Vitamin D is an important fat-soluble vitamin for maintaining vital activities. It has a variety of biological effects and pathophysiological significance. A growing number of studies are focusing on predictive value of vitamin D level and therapeutic effects in critically ill patients. Due to reduced intake, metabolic changes, increased clearance and blood dilution of vitamin D, vitamin D insufficiency or deficiency is prevalent in critically ill patients. It was proved that insufficient vitamin D was associated with poor outcomes in critically ill patients. Reviewing different studies exploring the therapeutic effects of vitamin D supplementation in critically ill patients, there were great heterogeneities in recruited population, research methods and results. Whether vitamin D supplementation helps improve clinical outcomes in critically ill patients is controversial. The target adaptation population of vitamin D treatment, the method and standard of monitoring and evaluation, the preparation and dosage, and the timing of supplementation may all affect the efficacy evaluation of vitamin D. It is of great significance to strengthen the monitoring of vitamin D level and to explore the effect of vitamin D supplementation on clinical outcomes in critically ill patients in China. This paper mainly discusses the application value and application prospect of vitamin D in the treatment of severe diseases.

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