维生素K 对营养性维生素D 缺乏性佝偻病患儿骨钙素羧化率的影响

目的:观察维生素K 对营养性维生素D 缺乏性佝偻病患儿骨钙素羧化率的影响,探讨维生素K 对佝偻病的治疗作用。方法:选择2016年3-12月在我院儿科就诊的佝偻病激期患儿80例,随机分为治疗组42例和对照组38例,对照组患儿服用维生素D 400 IU,每天1次,治疗组患儿在对照组治疗基础上加用维生素K4 4 mg/d,两组均连续用药2周,观察两组患儿用药前后血清骨钙素、羧化不全骨钙素水平及骨钙素羧化率的变化。结果:因家长不配合以及抽血困难、溶血等因素治疗组和对照组均有部分患儿退出研究,最终纳入分析的治疗组33例,对照组29例,两组患儿年龄、性别、体质量、母乳喂养状况比较差异无统计学意义(P>0.05)。治疗前两组患儿骨钙素、羧化不全骨钙素水平及骨钙素羧化率比较差异无统计学意义(P>0.05)。治疗后,两组患儿骨钙素水平比较差异无统计学意义(P>0.05),羧化不全骨钙素水平、骨钙素羧化率比较差异有统计学意义( P<0.05),治疗后治疗组羧化不全骨钙素水平低于对照组,骨钙素羧化率明显高于对照组。治疗组用药前后骨钙素水平、羧化不全骨钙素水平、羧化率比较差异有统计学意义(P<0.05)。结论:维生素K可以提高佝偻病患儿骨钙素的羧化率。

Effect of Vitamin K on Osteocalcin Carboxylation Rate in Children with Nutritional Vitamin D Deficiency Rickets

Objective: To observe the effect of vitamin K on osteocalcin carboxylation rate in children with nutritional vitamin Ddeficiency rickets, and to explore the therapeutic effect of vitamin K on rickets. Methods: Eighty children with rickets admitted into our hospital from Mar. 2016 to Dec. 2016 were selected to be randomly divided into treatment group (n =42) and control group (n =38). The control group was given vitamin D 400 IU once a day, while the observation group additionally received vitamin K4 4 mg/d based on the control group, and two groups were given medication for two weeks. Changes of serum osteocalcin, carboxylated incompleteosteocalcin and osteocalcin carboxylation rate were observed in two groups before and after treatment. Results: Some children in thetreatment group and the control group withdrew from the study because of parental discomfort and difficulties in blood draw andhemolysis, and finally 33 cases in the treatment group and 29 cases in the control group were included in the analysis, there were nosignificant differences in age, gender, body weight and breastfeeding status between two groups (P>0.05). There was no significantdifference in osteocalcin, carboxylated incomplete osteocalcin level and osteocalcin carboxylation rate between two groups beforetreatment (P>0.05). After treatment, there was no significant difference in osteocalcin level between two groups (P>0.05), thedifference was statistically significant between two groups in osteocalcin level and osteocalcin carboxylation rate (P<0.05), the level of carboxylated incomplete osteocalcin in treatment group was lower than that in control group, and the osteocalcin carboxylation rate was significantly higher than that in control group. There were significant differences in osteocalcin, carboxylated incomplete osteocalcin level and carboxylation rate in treatment group before and after treatment (P<0.05). Conclusion: Vitamin K can improve the carboxylation rate of osteocalcin in children with rickets.