维生素AD波浪式剂量给药方法对预防婴儿维生素D缺乏病的效果与意义  

Preventive Effect of Wave-dose of Vitamin AD on Vitamin D Deficiency Among Infants and Its Significance

作　　者：陈虾[1] 邓晓燕 叶郁辉[3] 杨少杰 

机构地区：[1]南方医科大学附属深圳市妇幼保健院儿童健康科,广东省深圳市518048 [2]深圳市福田区第二人民医院社区健康服务管理中心 [3]北京大学深圳医院预防保健科

出　　处：《中国全科医学》2015年第12期1425-1430,共6页Chinese General Practice

摘　　要：目的观察维生素AD安全范围内采用波浪式剂量给药方法对预防婴儿维生素D缺乏病的效果以及对婴儿健康管理的意义。方法 2011年1月—2013年1月南方医科大学附属深圳市妇幼保健院、北京大学深圳医院、深圳市福田区第二人民医院各选取200例符合纳入标准的婴儿作为研究对象（共600例）;按各单位保健门诊建档序号的末位数进行分组：编号末位数为奇数的分为波浪式剂量给药组（试验组,300例）,编号末位数为偶数的分为传统给药组（对照组,300例）。试验组在推荐的安全剂量范围内采用波浪式剂量、对照组按预防推荐剂量的固定剂量给予维生素AD。从出生后第28~42天进行第1次常规随访,之后每3个月（第3、6、9、12个月）随访1次,共随访5次。统计两组婴儿贫血、维生素D缺乏病相关症状、血清25-羟维生素D〔25-（OH）D〕异常、血清碱性磷酸酶（AKP）异常、骨骼指征异常发生率、年平均患病次数等指标。在研究6个月后,给家长发调查表进行经济性和简便性评分。观察两组婴儿的不良反应情况。结果全程因迁出等原因失访43例,最终共557例完成研究,其中试验组279例,对照组278例。两组婴儿贫血、骨骼指征异常发生率比较,差异无统计学意义（P〉0.05）;两组婴儿维生素D缺乏病相关症状、25-（OH）D异常、AKP异常发生率、年平均患病次数比较,差异有统计学意义（P〈0.05）。试验组每例婴儿1年需要维生素AD滴剂的数量为274粒,对照组为365粒。试验组每例婴儿1年补充维生素AD滴剂的费用为260.06元,对照组为346.75元。试验组经济性评分〔（8.5±0.9）分与（5.6±1.5）分〕和简便性评分〔（8.9±0.8）分与（5.6±1.3）分〕均高于对照组（P〈0.05）。两组在观察期间,未发现有维生素AD的急、慢性中毒情况。结论维生素AD安全剂量范围内的波浪式剂量给药方法在预防维生素D缺乏Objective To observe the preventive effect of wave-dose of vitamin AD on vitamin D deficiency among infants and its significance for children health management. Methods 600 infants from Shenzhen Maternal and Child Health Hospital Affiliated to Southern Medical University, Peking University Shenzhen Hospital and Futian Second People＇ s Hospital（ 200 infants per hospital） were selected as study subjects from January 2011 to January 2013. All cases were divided into wave-dose drug treatment group（ experiment group,300 cases） and traditional treatment group（ control group,300 cases） according to the health-recorder-number： the case whose number was odd entered experiment group,and the case whose number was even entered control group. The infants in experiment group were given the vitamin AD with wave-dose based on safe dose range,and the infants in control group were given the vitamin AD with regular recommended dose. The cases were first followed up 28-42 days after born,and were followed up 1 time every three months（ 3,6,9,12 months of age）,thus the cases were followed up for 5 times. The symptoms indicators of anemia and vitamin D deficiency disease,levels of 25-（ OH） D and AKP,skeletal anomalies and annual average frequency of sickness among two groups of cases were recorded. The treatment scores of economical efficiency and simplicity level were obtained from the completed questionaire by parents of cases. At the same time the adverse reactions related to vitamin AD were also recorded. Results Because of emigration and other reasons,43 cases were lost to follow-up,thus a total of 557 cases completed the study among whom 279 cases were in experiment group,278 cases were in control group. There was no significant difference in indicators of anemia and skeletal anomalies between two groups（ P〉0. 05）. There were significant differences in prevalence of symptoms of vitamin D deficiency disease,prevalence of abnormal 25-（ OH） D level,prevalence of abnormal AKP level, and annual averag

关 键 词：剂量效应关系 药物 波浪式剂量 儿童保健服务 维生素D缺乏病 

分 类 号：R723.244[医药卫生—儿科]