不同水平25-羟维生素D和多器官功能衰竭患者病情和预后的关系研究  

Relations between different levels of 25-hydroxyl vitamin D and condition and prognosis of patients with multiple organ failure

作　　者：陈伟[1] 陈勉[1] 胡志华[1] 

机构地区：[1]海南医学院附属医院重症医学科,海南海口570102

出　　处：《中国现代医学杂志》2015年第3期41-44,共4页China Journal of Modern Medicine

摘　　要：目的 探究不同水平的血清25-羟维生素D与多器官功能衰竭患者病情和预后的关系。方法 选择海南医学院附属医院于2011年1月-2013年1月收治的200例多器官功能衰竭患者,检测患者血清25-羟维生素D水平,并测定急性生理学与慢性健康状况评分系统Ⅱ（APACHEⅡ）,分析不同水平的血清25-羟维生素D与该类患者病情和预后的关系。结果 维生素D〈20μg/L患者的APACHEⅡ评分、衰竭器官数目、年龄、血培养阳性率、住院病死率、血肌酐水平等均显著高于血清25-羟维生素D水平≥30μg/L患者,差异有统计学意义（P〈0.05）;线性相关性分析结果显示,血清25-羟维生素D与住院病死率、APACHEⅡ评分、衰竭器官数目呈显著负相关关系（P〈0.05）,而与年龄、游离钙、IgG、血培养阳性率、总胆固醇（TC）、甘油三酯（TG）、血肌酐、高密度胆固醇（HDL-C）、低密度胆固醇（LDL-C）等指标均无显著相关性（P〉0.05）;多元回归分析结果显示,维生素D〈20μg/L是显著影响多器官功能衰竭患者预后的危险因素（O赞R2.131,95%CI 1.192~3.810）。结论 不同水平的血清25-羟维生素D对多器官功能衰竭患者病情和预后的影响存在差异,维生素D〈20μg/L明显增加死亡的危险。【Objective】To explore the relations between different levels of 25-hydroxyl vitamin D and condition and prognosis of patients with multiple organ failure. 【Methods】A total of 200 cases with multiple organ failure in our hospital from January 2011 to January 2013 were selected, and the levels of serum 25-hydroxyl vitamin D were detected, and the APACHEⅡ scores were measured. The relations between different levels of 25-hydroxyl vitamin D and condition and prognosis of those patients were analyzed. 【Results】The APACHEⅡ scores, organ failure number, age, intracellular free calcium, Ig G, the positive rate of blood culture, hospital mortality and serum creatinine level in the patients with vitamin D20μg/l were all significantly higher than those of the patients with vitamin D≥30μg/l, the differences were statistically significant（P〈0.05）. Linear correlation analysis showed that the level of25-hydroxyl vitamin D was significantly negatively correlated to the hospital mortality, APACHE Ⅱscores and organ failure number（P〈0.05）, but was not significantly correlated to age, intracellular free calcium, Ig G, the positive rate of blood culture, TC, TG, serum creatinine, HDL-C and LDL-C（P〉0.05）. Multiple regression analysis showed that vitamin D 20μg/l was the risk factor which significantly affected the prognosis of multiple organ failure（^OR ： 2.131,95% CI：1.192~3.810）. 【Conclusions】The influence of different levels of serum 25-hydroxyl vitamin D on the condition and prognosis of the patients with multiple organ failure is different, and vitamin D20μg/l significantly increases the risk of the death.

关 键 词：25-羟维生素D 多器官功能衰竭 病情 预后 回归分析 

分 类 号：R459.3[医药卫生—治疗学]