重症患者入ICU时多元维生素水平及临床相关性研究

目的：分析患者进入重症监护病房（ICU）24 h内的多元维生素水平及缺乏症，并进行临床相关性研究。方法：收集2022年2月 ~ 11月南京鼓楼医院收治的369例成人重症患者的临床数据，分析患者多元维生素水平及其与C反应蛋白（CRP）、序贯器官衰竭评分（SOFA）和全因死亡率等之间的相关性。 结果：重症患者VA、VD和VE缺乏症的发生率分别为42.01%、87.26%和22.49%。患者体内VA水平和CRP水平相关（P < 0.05）。VA、VD和VE水平之间呈正相关（P < 0.001）。VA和VD水平与SOFA呈负相关（P < 0.05）。369例患者中死亡85例，总体死亡率23.04%，死亡组患者的VA和VD水平以及VD缺乏症的发生率显著低于存活组（P < 0.05），VD缺乏、VA水平降低、VD水平降低、SOFA增加和机械通气时间延长为患者ICU住院期间全因死亡的相关因素。结论：重症患者普遍存在维生素缺乏，VA和VD水平与患者的预后相关，需要进一步研究维生素在重症患者中的作用。

Multivitamin Levels and Clinical Correlation in ICU Patients with Severe Illness

Objective: To analyze the multivitamin level and deficiency of patients within 24 h after admission to the intensive care unit (ICU), and to conduct clinical correlation study. Methods: Clinical data of 369 severe adult patients admitted to Nanjing Drum Tower Hospital from February to November 2022 were collected, and the correlations between multivitamin levels and C-reactive protein(CRP), sequential organ failure assessment (SOFA) and all-cause mortality were analyzed. Results: The incidence of vitamin A, D and E deficiency in severe patients were 42.01%, 87.26% and 22.49%, respectively. Vitamin A levels were correlated with C-reactive protein levels (P < 0.05). There were positive correlations between vitamin A, D and E levels (P < 0.001). The levels of vitamin A and D were negatively correlated with SOFA (P < 0.05). Of the 369 patients, 85 died, with an overall mortality of 23.04%. The levels of vitamin A and D and the incidence of vitamin D deficiency in the death group were significantly different from those in the survival group (P < 0.05). Vitamin D deficiency, decreased vitamin A and D levels, increased SOFA score, and prolonged mechanical ventilation were relevant factors for all-cause death during ICU stay. Conclusion: Vitamin deficiency is common in critically ill patients, and vitamin A and D levels are associated with the prognosis of patients. Further studies are needed to investigate the role of vitamins in critical patients.