不同剂量维生素D和钙剂治疗3～4月龄婴儿佝偻病早期的疗效分析  

Analysis of the effect of defferent doses of vitamin D and calcium on early rickets in 3-4 month old infants

作　　者：田晓博 高英[1] Tian Xiaobo;Gao Ying(Shenyang maternal and child hospital, Shenyang, Liaoning, 110011, China)

机构地区：[1]沈阳市妇婴医院儿保科,辽宁沈阳110011

出　　处：《当代医学》2018年第35期12-15,共4页Contemporary Medicine

摘　　要：目的了解3～4月龄婴儿补充不同剂量的维生素D和钙对改善佝偻病早期症状和骨密度的影响,为提高婴儿早期骨健康选择适合用量提供参考。方法选择2015年3月至2017年12月来沈阳市妇婴医院儿保门诊健康体检的3～4月龄佝偻病早期婴儿257名,随机分组补维生素D和钙并且1个月后复查,根据维生素D和钙的使用情况分5组(D 400 IU/d、D 800 IU/d、D 1 200 IU/d、D 800 IU/d+Ca 75 mg/d、D 800 IU/d+Ca 150 mg/d),采用卡方检验、方差分析和SNK检验,分析单纯补维生素D 3组(D 400 IU/d、D 800 IU/d、D 1 200 IU/d)症状改善差异和骨密度变化;以及在补D 800 IU/d前提下,补钙和未补钙者(D 800 IU/d、D 800 IU/d+Ca 75 mg/d、D 800 IU/d+Ca 150 mg/d)3组症状改善差异和骨密度变化。结果单补不同剂量维生素D的3组和补D 800 IU/d前提下予不同钙剂的3组,一个月症状改善情况和骨密度SOS变化均有显著差异,症状改善和消失者随着用D剂量增加而增多,骨密度SOS变化数值随着用D剂量增加而增加。SNK检验:400 IU/d组(3.070 5 m/s)和800 IU/d组(15.865 1 m/s)<1 200 IU/d组(62.928 7 m/s);D 800 IU/d组(15.865 1 m/s)<D 800 IU/d+Ca 75 mg/d组(44.003 4 m/s)和D 800 IU/d+Ca150 mg/d组(62.411 7 m/s)。结论维生素D用量增加到一定程度或者加钙剂均可改善佝偻病早期症状和骨骼钙化情况,维生素D增量不足时骨骼钙化改善并不明显;相同维生素D使用剂量的前提下,适量钙摄入有利于改善骨骼钙化,而钙量继续增加并不能使骨骼钙化更好。Objective To study on the effect of defferent doses of calcium and vitamin D on early symptoms of rickets and on bone mineral density in3-4month old infants,and provide reference for improving bone nutrition in early infant.Methods Subjects were257early rickets infants who were in3-4months old to request health examination in our child health clinic from Shenyang maternal and child hospital from Mar.2015to Dec.2017.They were divided into5groups based on the use of vitamin D and calcium(D400IU/d,D800IU/d,D1200IU/d,D800IU/d+Ca75mg/d,D800IU/d+Ca150mg/d),and a month's review.Chi-square test,variance analyses and SNK test was used to analyze the improvement of clinical symptoms and difference of the speed of sound(SOS)in3groups of vitamin D supplementation without calcium(D400IU/d,D800IU/d,D1200IU/d)and in3groups of vitamin D800IU/d supplementation with or without calcium(D800IU/d,D800IU/d+Ca75mg/d,D800IU/d+Ca150mg/d).Results In the3groups of vitamin D supplementation without calcium and in3groups of vitamin D800IU/d supplementation with or without calcium,there were significant differences in the improvement of clinical symptoms and the data of SOS improvement comparision.Symptoms improved and disappeared with increasing doses of vitamin D,and the data of SOS increased with the increase of vitamin D dose.SNK test:D400IU/d group(3.0705m/s)andD800IU/d group(15.8651m/s)<D1200IU/d group(62.9287m/s),D800IU/d group(15.8651m/s)<D800IU/d+Ca75mg/d group(44.0034m/s)and D800IU/d+Ca150mg/d group(62.4117m/s).Conclusion The increase of vitamin D to a certain extent and calcium additive can improve the early symptoms of rickets and the condition of bone calcification.When vitamin D is not enough,the improvement of bone calcification is not obvious.With the same dose of vitamin D,appropriate calcium intake is beneficial to improving bone calcification,but the increase in calcium does not make bone calcification better.

关 键 词：婴儿 佝偻病 骨密度 维生素D 钙 

分 类 号：R723.2[医药卫生—儿科]