迁延性腹泻患儿血锌变化及补锌治疗效果评价

目的探讨迁延性腹泻患儿血清锌水平变化及补锌治疗对迁延性腹泻的疗效。方法收集2007～2010年因迁延性腹泻在我院住院的患儿76例及同期在儿童保健科体检的健康儿童213例的末梢血,按年龄分组测定血锌,比较两组的血锌水平;并将迁延性腹泻患儿随机分为补锌治疗组40例,常规治疗组36例,常规治疗组患儿给予蒙脱石散、微生态制剂及补液等治疗;补锌治疗组在常规治疗的基础上口服葡萄糖酸锌片20 mg/d(6个月以下者10 mg/d),连续治疗14 d,治疗后检测血锌水平。对腹泻组患儿于出院后随访3个月,观察其腹泻再发生次数、体重增长等情况。结果 (1)迁延性腹泻患儿血锌水平明显低于本地区同龄健康儿童血锌水平(P0.01);(2)治疗总有效率补锌治疗组为95.0%,常规治疗组为77.8%,补锌组高于常规治疗组(P0.05);(3)疗程补锌治疗组为(8.3±2.8)d,常规治疗组为(11.6±3.1)d,补锌组短于常规治疗组(P0.01);(4)补锌治疗组患儿治疗后血锌值与健康对照组比较,差异无统计学意义(P0.05);(5)出院后3个月内,补锌组患儿再发生腹泻(2.3±1.1)人次,常规治疗组再发生腹泻(4.6±2.3)人次,补锌组少于常规治疗组(P0.01);(6)合并营养不良者,补锌能增加其体重。结论迁延性腹泻患儿血锌水平降低,补锌可提高其临床疗效及缩短疗程。

The change of blood zinc and effect of zinc supplementation treatment in persisting diarrhea children

Objective To explore the change of blood zinc and the curative effect of zinc supplementation treatment in persisting diarrhea children.Methods The peripheral blood of 76 persisting diarrhea children in our hospital and 213 healdiy children who had a physical examination in Child’s Health Care from 2007 to 2010 were col- lected.The blood zinc was determined according to age groups,blood level of zinc was compared between two groups. And persisting diarrhea children were randomly divided into zinc supplementation treatment group(40 cases) and routine therapy group(36 cases).the routining therapy group were given montmorillonite powder,micro-ecological agents and fluid infusion treatment,etc;Zinc supplementation treatment group were given oral zinc gluconate tablets 20 mg/d(children below 6 months,10 mg/d) based on routine treatment for 14 d.The blood level of zinc was detected after treatment.After discharge,3 months,follow-up visit were given to persisting diarrhea children to observe the diarrhea frequency and weight gain,etc.Results(1) Zinc level of persisting diarrhea children was obviously lower than that of healthy children of the same age(P<0.01);(2) Total effective rate was 95.0%in the zinc supplementation treatment group and 77.8%in the routine therapy group,respectively,having significant difference(P<0.05);(3) The average course of treatment were(8.3±2.8)din the zinc supplementati on treatment group and(11.6±3.l)d in the routine therapy group(P<0.01);(4) After treatment there was no significant difference between blood zinc between the zinc supplementation treatment group and health control group(P>0.05);(5) Three months after discharge,diarrhea recurrence were(2.3±1.1) times in zinc treatment group and(4.6±2.3) times in routine therapy group(P<0.01);(6)Zinc supplementation can increase weight of the children with malnutrition.Conclusion Blood zinc level of persisting diarrhea children was lower,zinc supplementation can increase the chnical efficacy and shorten the period of treatment.