摘要脓毒症是重症监护室常见的危重症，总体预后较差，病死率较高。脓毒症发生机制的研究对脓毒症的预防和治疗具有重要的临床意义。近年来，维生素D（Vit D）与脓毒症的关系逐渐受到重视，研究发现,Vit D 在脓毒症全身炎症反应综合征（SIRS）和机体对病原菌免疫防御反应等机制中起重要作用。本文就近期相关研究进展做一综述。
杨家来， 徐 俊（综述）， 张 泓（审校）. 维生素D 水平与脓毒症发生机制及临床诊治
的研究进展[J]. 中国急救医学, 2016, 36(5): 393-396.
YANG Jia-lai, XU Jun, ZHANG Hong. Research progress in pathogenesis and clinical diagnosis and treatment between vitamin D levels
and sepsis. Chinese Journal of Critical Care Medicine, 2016, 36(5): 393-396.
[1] El-Khoury JM，Reineks EZ，Wang S. Progress of liquid chromatography-mass spectrometry in measurement of vitamin D metabolites and analogues[J]. Clin Biochem，2011，44（1）:66-76.
[2] Holick MF. Resurrection of vitamin D deficiency and rickets[J]. J Clin Invest，2006，116（8）:2062-2072.
[3] Baeke F，Takiishi T，Korf H，et al. Vitamin D: modulator of the immune system[J]. Curr Opin Pharmacol，2010，10（4）:482-496.
[4] Holick MF，Binkley NC，Bischoff-Ferrari HA，et al. Evaluation，treatment，and prevention of vitamin D deficiency: an Endocrine Society clinical practice guideline[J]. J Clin Endocrinol Metab，2011，96（7）:1911-1930.
[5] Looker AC，Johnson CL，Lacher DA，et al. Vitamin D status: United States，2001-2006[J]. NCHS Data Brief，2011，59:1-8.
[6] Kempker JA，Han JE，Tangpricha V，et al. Vitamin D and sepsis: an emerging relationship[J]. Dermatoendocrinol，2012，4（2）:101-108.
[7] Moromizato T，Litonjua AA，Braun AB，et al. Association of low serum 25-hydroxyvitamin D levels and sepsis in the critically ill[J].Crit Care Med，2014，42（1）:97-107.
[8] Watkins RR. Investigating the association between vitamin D deficiency and sepsis: challenges and future prospects[J]. Expert Rev Anti Infect Ther，2012，10（7）:723-725.
[9] Thomason J，Rentsch C，Stenehjem EA，et al. Association between vitamin D deficiency and methicillin-resistant Staphylococcus aureus infection[J]. Infection，2015，43（6）:715-722.
[10] Zhang C，Zhao L，Ding Y，et al. Enhanced LL-37 expression following vitamin D supplementation in patients with cirrhosis and spontaneous bacterial peritonitis[J]. Liver Int，2016，36（1）:68-75.
[11] Kroner Jde C，Sommer A，Fabri M. Vitamin D every day to keep the infection away[J]. Nutrients，2015，7（6）:4170-4188.
[12] 郭剑颖，何忠杰. 脓毒症的免疫调理治疗[J]. 中国急救医学，2012，32（6）:546-549.
[13] Equils O，Naiki Y，Shapiro AM，et al. 1，25-Dihydroxyvitamin D inhibits lipopolysaccharide- induced immune activation in human endothelial cells[J]. Clin Exp Immunol，2006，143（1）:58-64.
[14] Bartley J. Vitamin D: emerging roles in infection and immunity[J].Expert Rev Anti Infect Ther，2010，8（12）:1359-1369.
[15] 张烈，严一核，谢渭根. 连续性血液滤过治疗对严重脓毒症患者炎症介质及单核细胞中TLR4 和miRNA-146a 的影响[J]. 中国急救医学，2013，33（11）:961-965.
[16] St-Arnaud R，Arabian A，Yu VW，et al. 1alpha，24（S）（OH）2D2 normalizes bone morphology and serum parathyroid hormone without hypercalcemia in 25- hydroxyvitamin D- 1- hydroxylase（CYP27B1）- deficient mice，an animal model of vitamin D deficiency with secondary hyperparathyroidism[J]. J Endocrinol Invest，2008，31（8）:711-717.
[17] Barnett N，Zhao Z，Koyama T，et al. Vitamin D deficiency and risk of acute lung injury in severe sepsis and severe trauma: a case-control study[J]. Ann Intensive Care，2014，4（1）:5.
[18] Ryz NR，Patterson SJ，Zhang Y，et al. Active vitamin D（1，25-dihydroxyvitamin D3）increases host susceptibility to Citrobacter rodentium by suppressing mucosal Th17 responses[J]. Am J Physiol Gastrointest Liver Physiol，2012，303（12）:G1299-1311.
[19] Chun RF，Lauridsen AL，Suon L，et al. Vitamin D-binding protein directs monocyte responses to 25- hydroxy- and 1，25- dihy⁃droxyvitamin D[J]. J Clin Endocrinol Metab，2010，95（7）:3368-3376.
[20] Medlej-Hashim M，Jounblat R，Hamade A，et al. Hypovitaminosis D in a Young Lebanese Population: Effect of GC Gene Polymor⁃phisms on Vitamin D and Vitamin D Binding Protein Levels[J].Ann Hum Genet，2015，79（6）:394-401.
[21] Uberti F，Lattuada D，Morsanuto V，et al. Vitamin D protects human endothelial cells from oxidative stress through the autophagic and survival pathways[J]. J Clin Endocrinol Metab，2014，99（4）:1367-1374.
[22] Upala S，Sanguankeo A，Permpalung N. Significant association between vitamin D deficiency and sepsis: a systematic review and meta-analysis[J]. BMC Anesthesiol，2015，15:84.
[23] Matthews LR，Ahmed Y，Wilson KL，et al. Worsening severity of vitamin D deficiency is associated with increased length of stay，surgical intensive care unit cost，and mortality rate in surgical intensive care unit patients[J]. Am J Surg，2012，204（1）:37-43.
[24] Perron RM，Lee P. Efficacy of high-dose vitamin D supplementation in the critically ill patients[J]. Inflamm Allergy Drug Targets，2013，12（4）:273-281.
[25] Bjelakovic G，Gluud LL，Nikolova D，et al. Vitamin D supplemen⁃tation for prevention of mortality in adults[J]. Cochrane Database Syst Rev，2014，1:CD007470.
