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两例低血磷抗D佝偻病均从婴幼儿时期发病,曾用大剂量VitD治疗无效,至2~3岁后仍表现活动期佝偻病。患儿身材矮小,下肢严重畸形,髋关节外翻,膝关节内翻或外翻畸形。X线表现长骨骨质普遍稀疏,干骺端毛糙,呈杯口状,钙化带消失。血生化检查血钙正常,低血磷,AKP增高,尿磷增高,尿钙正常。经用双氢速固醇(Dihydrotachysterol,DHT,AT10,德国产)治疗后病情明显改善,骨质增浓,干骺端出现明显钙化影。治疗效果良好。本文还指出,对迁延性佝偻病病人应注意本病的发生。
Two cases of hypophosphatemic anti-D rickets were infants and young children from the onset, once treated with high-dose VitD ineffective, to 2 to 3 years of age still showed active rickets. Children with short stature, severe lower limb deformity, hip valgus, varus or valgus knee deformity. X-ray showed long bone bone sparse, metaphyseal rough, cup-shaped mouth, calcification zone disappears. Blood biochemical examination of normal calcium, hypophosphatemia, AKP increased urinary phosphorus increased urinary calcium normal. After dihydrotachysterol (DHT, AT10, Germany) treatment significantly improved the condition, bone thickening, metaphyseal obvious calcification. The treatment effect is good. This article also pointed out that patients with persistent rickets should pay attention to the occurrence of the disease.