昆明医科大学学报2025，Vol.46Issue(2)：51-58,8.DOI:10.12259/j.issn.2095-610X.S20250208
老年脓毒症患者不同维生素D3水平与免疫炎症指标相关性分析
Correlation Analysis between Different Vitamin D3 Levels and Immune Inflammatory Indicators in Elderly Patients with Sepsis
摘要
Abstract
Objective To explore the correlation between serum vitamin D(VD3)level differences and immune inflammatory markers in elderly sepsis patients.Methods A total of 103 elderly patients with sepsis(aged 65-99 years)in the ICU of the First Affiliated Hospital of Kunming Medical University from January 2020 to December 2022 were collected and divided into two groups according to the diagnostic criteria for VD3 deficiency:VD3 deficiency group(n=32)and VD3 severe deficiency group(n=71).Correlation analysis was conducted by comparing the differences in serum 25-(OH)-D3(VD3)levels,immune function-related indicators upon admission(blood routine,infection-related proteins,combined detection of 12 cytokines,absolute count analysis of lymphocytes and subgroups,quantitative determination of infection-related immune cells,immunoglobulin,and complement),illness severity,and prognostic indicators(APACHE-II score,SOFA score,duration of ICU stay,and 28-day mortality rate).Result(1)Serum VD3 levels were lower in elderly patients with sepsis.No patient was in the VD3 normal or insufficient group.Patients with severe VD3 deficiency had higher APACHE-II scores,SOFA scores,and 28-day mortality rates than those with VD3 deficiency,and these scores were negatively correlated with serum VD3 levels(P<0.001),while the difference in ICU stay duration between the two groups was not statistically significant(P>0.05);(2)WBC,PCT,CRP,and CD4/CD8 in the VD3 deficiency group were all lower than those in the VD3 severe deficiency group(P<0.05),while IL-6,IL-10,CD45+,CD3+/CD45+,and CD19+Abs were all higher than those in the VD3 severe deficiency group(P<0.05);In the VD3 deficiency group,VD3 levels were positively correlated with CD45+(P<0.05 for all),while negatively correlated with IL-6,IL-10,PCT,and CRP(P<0.05 for all);In the VD3 severe deficiency group,there were fewer corre-lation indicators and the correlation strength was not as strong as that in the VD3 deficiency group.Conclusion(1)Elderly patients with sepsis generally have lower levels of VD3,with lower levels associated with more severe illness and poorer prognosis;(2)In elderly sepsis patients,compared to patients with severe VD3 deficiency,patients with VD3 deficiency have lower levels of inflammation,stronger cellular immune response,and stronger correlation,suggesting that the effects of different VD3 levels on immune inflammatory responses may vary in elderly sepsis patients.关键词
25-羟基维生素D3/免疫功能/脓毒症/老年患者/预后Key words
25-hydroxyvitamin D3/Immune function/Sepsis/Elderly patients/Prognosis分类
医药卫生引用本文复制引用
李从信,岳海东,朱鹏熹,黄光仙,沐领捷,彭亚男,王怡洁,杨洋..老年脓毒症患者不同维生素D3水平与免疫炎症指标相关性分析[J].昆明医科大学学报,2025,46(2):51-58,8.基金项目
国家自然科学基金(82460370,81960109) （82460370,81960109）
云南省急诊创伤性疾病临床医学中心项目 （）
云南省老年疾病临床医学研究中心-老年共病诊疗及临床转化研究项目(202102AA310069) （202102AA310069）
云南省代谢相关性脂肪肝研究创新团队(202305AS350019) （202305AS350019）
