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本文报告1例20个月男孩患维生素D依赖性佝偻病,出现多发性骨折及呼吸衰竭。患儿入院时呼吸浅促,双肺呼吸音减低,满布湿性捻发音,肋骨可触及念珠,股骨弯曲,四肢畸形。X线检查:四肢骨质疏松、骨膜下骨质吸收,长骨9处骨折及多发性肋骨骨折,血钙、磷降低,硷性磷酸酶增高,多种氨基酸尿。入院后头2个月发生11次呼吸困难,需气管内插管应用人工呼吸机。入院初曾用钙、磷治疗3周,并每隔6天注射麦角固醇60万IU,共2次未有任何改善。改用1-α-羟基胆骨化醇0.61μg/kg/天,血清硷性磷酸酶在数夭内迅速显著下降。3个月后临床及生化检查结果显著改善,硷性磷酸酶正常,多种氨基酸消失,骨折愈合,骨钙化增加,血清钙、磷维持正
This article reports 1 case of 20-month-old boy suffering from vitamin D-dependent rickets, multiple fractures and respiratory failure. Children admitted to hospital, shallow breathing, lung breath sounds reduced, covered with wet twisting sound, ribs can reach rosary, femur bending, limb deformities. X-ray examination: limb osteoporosis, subperiosteal bone resorption, long bone fractures and multiple fractures of the ribs, calcium, phosphorus, alkaline phosphatase increased, a variety of amino aciduria. Eleven times of dyspnea occurred in the first 2 months after admission, and an endotracheal intubation was required to use artificial respirator. At the beginning of admission, calcium and phosphorus were used for 3 weeks and 600,000 IU of ergosterol were injected every 6 days without any improvement in 2 times. Use of 1 -α-hydroxy cholecalciferol 0.61μg / kg / day, serum alkaline phosphatase rapidly decreased significantly within a few days. Three months after clinical and biochemical test results improved significantly, normal alkaline phosphatase, a variety of amino acids disappear, fracture healing, increased bone calcification, serum calcium and phosphorus were positive