【摘要】 慢性阻塞性肺疾病（chronic obstructive pulmonary disease,COPD）是以持续的气流受限为特征的慢性炎症性呼吸系统疾病，不仅严重影响患者的生活质量，并且造成沉重的社会与医疗经济负担。维生素D在调节钙磷代谢、维持骨骼健康及肌肉功能中发挥重要作用。近年来研究表明，维生素D缺乏可增加肺部炎症性疾病的发病风险，且与COPD严重程度、急性加重风险及肺功能下降密切相关。维生素D缺乏作为COPD患者常见的合并症之一，血清25-羟基维生素D水平降低可促进肺部促炎因子释放、抑制抗炎因子表达，加重气道及肺组织慢性炎症损伤，抑制肺泡上皮修复与再生，加速肺纤维化，进而加剧气流受限。同时，维生素D缺乏还会导致骨骼肌功能减退、运动耐力下降及呼吸困难加重。然而，目前补充维生素D对COPD患者肺功能、病死率等临床结局的影响仍存在争议。规范监测与合理补充维生素D可作为COPD综合管理的重要措施，有助于改善患者预后。文章就维生素D在COPD中的作用机制、研究进展及当前存在的争议与局限性进行综述，为COPD的临床诊治与管理提供参考。更多还原

【Abstract】 Chronic obstructive pulmonary disease(COPD) is a chronic inflammatory respiratory disease characterized by persistent airflow limitation. It not only severely affects the quality of life of patients but also imposes a heavy burden on society and the medical economy. Vitamin D plays a crucial role in regulating calcium and phosphorus metabolism, maintaining bone health, and muscle function. Recent studies have shown that vitamin D deficiency can increase the risk of pulmonary inflammatory diseases, and is closely related to the severity of COPD, the risk of acute exacerbation, and the decline in lung function. Vitamin D deficiency, as one of the common complications in patients with COPD, leads to a decrease in serum 25-hydroxyvitamin D levels, which can promote the release of pro-inflammatory factors in the lungs, inhibit the expression of anti-inflammatory factors, aggravate chronic inflammatory damage in the airways and lung tissues, inhibit the repair and regeneration of alveolar epithelium, accelerate pulmonary fibrosis, and thereby exacerbate airflow limitation. At the same time, vitamin D deficiency also causes decreased muscle function, reduced exercise endurance, and increased breathing difficulties. However, the impact of vitamin D supplementation on clinical outcomes such as lung function and mortality in COPD patients remains controversial. Standardized monitoring and rational supplementation of vitamin D can be an important measure for comprehensive management of COPD, which is helpful in improving patient prognosis. This article reviews the mechanism of action of vitamin D in COPD, research progress, and current controversies and limitations, providing a reference for the clinical diagnosis, treatment, and management of COPD.更多还原