维生素在败血症中的作用:叙述性审查
Paweł Radkowski1,2,3, Anna Gogojewicz4, Joanna Charasna5,6
1Department of Anaesthesiology and Intensive Care, Faculty of Medicine, Collegium Medicum, University of Warmia and Mazury, 10-719 Olsztyn, Poland.
Nutrients
|November 13, 2025
概括
选择的维生素可以通过恢复代谢平衡来支持败血症治疗. 维生素D看起来很有前途,而胺对缺乏维生素的患者有好处,但对其他人的证据仍然有限.
科学领域:
- 临界护理医学 临界护理医学
- 营养生物化学 营养生物化学
- 免疫学 免疫学 免疫学
背景情况:
- 败血症在重症监护中是一个重大挑战,原因是高死亡率和复杂的代谢障碍.
- 目前的败血症疗法有效性有限,引发了对维生素补充等支持性干预措施的兴趣.
- 维生素具有性效应,使其成为治疗败血症相关代谢和免疫问题的潜在候选者.
研究的目的:
- 总结目前关于维生素C,D,B1,B9和B12在败血症管理中的作用的证据.
- 突出作用机制,潜在的临床益处和毒症维生素补充剂的局限性.
- 评估维生素补充剂的疗效,特别是综合干预和随机对照试验在严重的败血症和败血性休克中.
主要方法:
- 综合文献分析,包括临床试验和元分析.
- 关注随机对照试验和评估组合维生素干预措施的研究.
- 对严重败血症和败血性休克患者维生素疗效的评估.
主要成果:
- 维生素D显示出潜在的治疗益处,特别是在呼吸衰竭的严重败血症中,当达到适当度时.
- 胺 (维生素B1) 可能通过改善线粒体功能和降低功能衰竭风险,对缺乏维生素B1的患者有好处.
- 对叶酸 (B9) 和胺 (B12) 的证据是不确定的;维生素C缺乏一致的减少死亡率的证据.
结论:
- 维生素补充剂可以作为标准败血症治疗的辅助剂,需要基于营养状况和代谢表型的个性化方法.
- 通过标准化剂量协议和精心设计的临床试验进行进一步的研究对于优化基于表型的个性化败血症管理至关重要.
- 个性化维生素策略可以增强败血症护理,但需要强有力的临床验证来确认有效性和安全性.
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