文献类型：期刊文献

中文题名：维生素D在假体周围感染防治中的应用研究进展

英文题名：Research advances in use of vitamin D for the prevention and treatment of periprosthetic joint infection

作者：田志敏[1,2];谢佳佳[3];王静[2];何淳诺[2];吴昊越[4];李焕玺[2];周亚鹏[2];张浩强[2]

第一作者：田志敏

机构：[1]解放军联勤保障部队第940医院关节外科,甘肃兰州730000;[2]甘肃中医药大学第一临床医学院,甘肃兰州730000;[3]陇西县人民医院儿科,甘肃定西748100;[4]解放军南部战区总医院骨科,广东广州510000

第一机构：解放军联勤保障部队第940医院关节外科,甘肃兰州730000

年份：2025

卷号：50

期号：12

起止页码：1627

中文期刊名：解放军医学杂志

外文期刊名：Medical Journal of Chinese People's Liberation Army

收录：;北大核心:【北大核心2023】；

基金：兰州市青年科技人才创新项目(2023-2-28);解放军联勤保障部队第940医院科研计划项目(2023YXKY014)。

语种：中文

中文关键词：假体周围感染;维生素D;预防;治疗

外文关键词：periprosthetic joint infection;vitamin D;prevention;treatment

摘要：假体周围感染(PJI)是关节置换术后的严重并发症,其防治面临巨大挑战。维生素D在钙磷代谢中发挥关键作用,同时具备免疫调节与抗菌活性:一方面可调节免疫反应,增强免疫细胞活性,促进抗菌肽生成,从而有效抵御病原菌入侵;另一方面可影响炎症因子的表达,改善假体周围组织微环境,降低PJI发生风险。临床前及临床研究发现,血清25-羟基维生素D[25(OH)D]<20 ng/ml与PJI的发生风险增加相关,靶向补充维生素D可降低关节置换术后感染率。但目前共病人群的精确剂量方案及患者特异性补充策略尚不明确。本文总结血清维生素D水平的判断标准及其与PJI发生的相关性,以期为维生素D及其相关试剂在PJI防治中的应用提供依据。
Periprosthetic joint infection(PJI),a severe complication following joint arthroplasty,poses significant challenges in prevention and management.Vitamin D plays a pivotal role in calcium-phosphate metabolism while demonstrating immunomodulatory functions and antimicrobial activity.Mechanistically,it regulates immune responses by enhancing phagocytic cell activity and promoting antimicrobial peptide production,thereby effectively combating pathogenic invasion.Moreover,vitamin D modulates inflammatory cytokine expression,improves the periprosthetic tissue microenvironment,and reduces PJI risk.Preclinical and clinical studies have revealed that serum 25-hydroxyvitamin D[25(OH)D]levels<20 ng/ml correlate with increased PJI incidence,whereas targeted vitamin D supplementation decreases postoperative infection rates.However,optimal dosing regimens for comorbid populations and patient-specific supplementation strategies remain undefined.This review summarizes the criteria for determining serum vitamin D levels and their correlation with the occurrence of PJI,in order to provide a basis for the application of vitamin D and related reagents in the prevention and treatment of PJI.