维生素D缺乏对老年重症患者预后的影响  

The evaluation of vitamin D deficiency on prognosis for elderly patients in severe illness

作　　者：王燕[1] 袁惠敏[1] 高艳红[1] 陈书艳[1] 

机构地区：[1]上海交通大学医学院附属新华医院老年科,上海200092

出　　处：《中国医师杂志》2017年第11期1668-1671,共4页Journal of Chinese Physician

摘　　要：目的调查老年重症患者维生素D缺乏情况，探讨维生素D缺乏对老年重症疾病预后的影响。方法收集老年重症监护室患者临床资料325例，检测血清25（OH）D，分为25（OH）D充足组、不足组和缺乏组；组间比较主要生化指标、急性生理学与慢性健康状况评分系统I／（A—PACHEⅡ）评分、多器官功能障碍综合征（MODS）发生率、30d死亡率等差异；多因素Logistic回归分析影响老年重症患者预后的独立因素。结果34．77％（113／325）的老年重症患者维生素D缺乏。与维生素D充足组比较，维生素D缺乏组的血浆乳酸、APACHEⅡ评分、MODS发生率、30d死亡率均增高，差异有统计学意义（P〈0．05）。多因素分析提示维生素D缺乏是影响老年重症患者预后的独立危险因素。结论老年重症监护室患者普遍存在不同程度维生素D缺乏，可能是影响疾病预后的独立危险因素。Objective To investigate the prevalence of vitamin D deficiency in elderly patients in severe illness and its relationship with severity of disease and prognosis. Methods Totally 325 inpatients admitted to geriatric intensive care unit were included in this study. Serum 25-hydroxyvitamin D [ 25-（OH） D] was examined. Main laboratory findings, the incidence of multiple organ dysfunction syndrome （MODS） , Acute Physiology and Chronic Health Evaluation （APACHE Ⅱ ） score and mortality rate of 30- day were compared among patients with different serum 25 （OH） D levels. Potential risk factors for mortality were analyzed by multivariate Logistic regression analysis. Results 25 （OH）D deficiency was identified in 113 （ 34. 77% ）. Compared to 25 （OH） D sufficiency group, 25 （OH） D deficiency group has significantly higher plasma lactic acid,APACHE n score, the incidence of MODS and mortality rate of 30-day, P 〈 0. 05. Analysis by multiple logistic regression suggested that 25 （OH） D deficiency was independent risk fac- tor for mortality. Conclusions Vitanfin D deficiency is highly prevalent among elderly patients with severe illness, and may be an independent risk factor for mortality.

关 键 词：维生素D缺乏 危重病 预后 

分 类 号：R591.44[医药卫生—内科学]