新英格兰医学杂志研究称:危重症患者补充维生素D无益

2019-12-15 xujing 中国循环杂志

维生素D缺乏在人群中普遍存在,危重症患者中尤为常见。近日,新英格兰医学杂志发表的一项研究提示,对于维生素D缺乏的危重病患者,早期给予54万IU的维生素D3可纠正维生素D缺乏,但未能降低死亡率或改善预后。研究纳入1078例维生素D缺乏的危重症患者(25-羟基维生素D<20 ng/ml [50 nmol/l])。在危重病早期(进入重症监护病房之前)进行随机分组,治疗组531例患者,安慰剂组528

维生素D缺乏在人群中普遍存在,危重症患者中尤为常见。

近日,新英格兰医学杂志发表的一项研究提示,对于维生素D缺乏的危重病患者,早期给予54万IU的维生素D3可纠正维生素D缺乏,但未能降低死亡率或改善预后。

研究纳入1078例维生素D缺乏的危重症患者(25-羟基维生素D<20 ng/ml [50 nmol/l])。在危重病早期(进入重症监护病房之前)进行随机分组,治疗组531例患者,安慰剂组528例患者。

治疗组患者第3天25-羟基维生素D的平均水平为46.9±23.2 ng/ml,安慰剂组为11.4±5.6ng/ml。

治疗组90天死亡率为23.5%,安慰剂组为20.6%,两组无差异。

甚至在某些亚组比如脓毒症、感染性肺炎、急性呼吸窘迫综合征患者,补充维生素D的死亡率高于安慰剂组。两组之间在次要临床、生理或安全终点方面也没有差异。

本试验结果不支持危重病人维生素D缺乏症的早期检测或治疗。

来源:The National Heart, Lung, and Blood Institute PETAL Clinical Trials Network. Early High-Dose Vitamin D3 for Critically Ill, Vitamin D–Deficient Patients. N ENGL J MED.December 11, 2019.

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    2019-12-16 lovetcm

    只能说明现在救治水平又提高了

    0

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