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目的探讨锌、维生素D联合钙治疗婴幼儿佝偻病的临床疗效及相关生化指标变化情况。方法选择儿童保健门诊2014年5月至2016年1月诊断为维生素D缺乏性佝偻病的110例婴幼患儿作为研究对象,通过随机方法将所选患儿分为对照组和观察组,每组55例。对照组患儿采用维生素D3结合碳酸钙进行治疗,观察组患儿在对照组治疗基础上给予葡萄糖酸锌口服液进行治疗,比较两组患儿治疗前后血清25-OHD3、钙(Ca2+)、脱氧吡啶啉(DPD)、骨源性碱性磷酸酶(BALP)及骨钙素(BGP)含量的变化情况用以评价预防用药的效果。随访2年,比较两组患儿血清25-OHD3、DPD含量、佝偻病复发率及骨密度用以评价用药后的远期治疗效果,记录并比较两组患儿用药后出现的不良反应。结果与治疗前比较,治疗后两组患儿Ca2+、DPD、25-OHD3、BGP及BALP含量均显著升高(P<0.05),且观察组患儿治疗后Ca2+、DPD、25-OHD3、BGP及BALP含量均明显高于同期对照组(P<0.05)。随访2年,观察组患儿的骨密度、25-OHD3及BALP水平明显高于对照组,差异有统计学意义(P<0.05);且观察组患儿的佝偻病复发率亦明显低于对照组,差异有统计学意义(P<0.05)。用药期间两组患儿均出现轻微不良反应且在停药后均自行消失,两组患儿并发症发生率比较差异未见统计学意义(P>0.05)。结论锌、维生素D联合钙在治疗婴幼儿佝偻病方面的近、远期疗效均较理想,安全性高,对临床预防婴幼儿佝偻病及促进婴幼儿骨质形成具有较高的价值,值得在临床推广使用。
Objective To investigate the clinical efficacy of zinc and vitamin D combined with calcium in the treatment of infantile rickets and the changes of related biochemical indexes. Methods A total of 110 infants and young children diagnosed with vitamin D deficiency rickets from May 2014 to January 2016 were selected as study subjects. The selected children were randomly divided into control group and observation group. Each group 55 cases. The children in the control group were treated with vitamin D3 and calcium carbonate. The children in the observation group were treated with oral gluconate on the basis of the control group. The serum levels of 25-OHD3, calcium (Ca2 +), deoxygenation Pyridinoline (DPD), bone alkaline phosphatase (BALP) and osteocalcin (BGP) were measured to evaluate the effect of prophylaxis. Followed up for 2 years, compared the two groups of children with serum 25-OHD3, DPD content, rickets recurrence rate and bone mineral density to evaluate the long-term treatment effect after treatment, record and compare the two groups of children after treatment of adverse reactions. Results Compared with those before treatment, the levels of Ca2 +, DPD, 25-OHD3, BGP and BALP in both groups were significantly increased after treatment (P <0.05), and the levels of Ca2 +, DPD, 25-OHD3, BGP And BALP were significantly higher than the control group (P <0.05). The follow-up of 2 years showed that the BMD, 25-OHD3 and BALP in the observation group were significantly higher than those in the control group (P <0.05), and the recurrence rate of rickets in the observation group was also significantly lower than that in the control group , The difference was statistically significant (P <0.05). There was slight adverse reactions in both groups during treatment and both disappeared on their own. The incidence of complications in both groups showed no significant difference (P> 0.05). Conclusions Zinc, vitamin D combined with calcium in the treatment of infant rickets have short-term and long-term curative effects, which are of high value in clinical prevention of rickets in infants and young children and promotion of bone formation in infants and young children, and are worthy of clinical promotion use.