Relationship Between Vitamin D With Organ Dysfunction Induced By Sepsis And Prognosis

Objective:AIM To investigate the effect of enteral supplementation of exogenous vitamin D on organ function in patients with sepsis and the effect on calcium,phosphorus and 28-day prognosis.Methods:A prospective randomized,single-blind placebo-controlled study was conducted in88 patients with sepsis who were admitted to ICU for more than 7 days.According to the level of 25-hydroxyvitamin D（25OHD）,the patients were divided into two groups:vitamin D deficiency(25OHD<30 nmol·L^-1)and vitamin D insufficient(25OHD 30-49.9 nmol·L^-1).And then they were randomly divided into two groups:treatment group(alfacalcidol soft capsule 0.5?g·d^-1)and placebo group(starch capsule 0.5?g·d^-1),given orally or via gastric tube and enteral nutrition tube for 7 days.The serum levels of25OHD,blood routine,liver and kidney function,calcium,phosphorus,arterial blood gas,acute physiological function and chronic health evaluationⅡ（APACHEⅡ）score,sequential organ failure assessment（SOFA）score and 28-day prognosis were observed.Results:A total of 80 patients completed the trial,40 patients with vitamin D deficiency and40 patients with insufficient vitamin D.There were 20 cases in the treatment group and20 cases in the placebo group.After intervention,the level of 25OHD increased in the treatment group and decreased in the placebo group,but there was no significant difference between the two groups（P>0 05）.Serum calcium and phosphorus levels in the treatment group were significantly higher than those in the placebo group（P<0.05）.APACHEⅡand SOFA scores decreased after intervention,but there was no significant difference between the treatment group and the placebo group（P>0.05）.There was no significant difference in 28-day mortality between the treatment group and the placebo group（P>0.05）.There were no adverse reactions such as hypersensitivity,hypercalcemia or hyperphosphatemia in the course of the experiment.Conclusion:The insufficient or deficiency of vitamin D level in patients with ICU sepsis is serious.Administration of exogenous vitamin D can increase the levels of calc ium and phosphorus in the body.However,this study showed no improvement in organ function and 28-day prognosis.