维生素D联合不同钙剂治疗婴幼儿佝偻病临床比较分析

目的比较不同剂型维生素D与铁锌钙或单纯钙剂联合治疗婴幼儿佝偻病的临床疗效。方法 175例维生素D缺乏性佝偻病患儿随机分为大剂量维生素D3联合铁锌钙治疗组72例（Ⅰ）、大剂量维生素D3联合钙剂治疗组68例（Ⅱ）和小剂量维生素D2联合钙剂治疗组35例（Ⅲ）,三组患儿治疗4、8周后进行疗效对比分析,治疗12周后比较三组血红蛋白浓度变化。结果治疗4周后,Ⅰ组与Ⅱ组比较,治疗有效率差异无统计学意义（P〉0.05）;Ⅰ组与Ⅲ组比较,治疗有效率明显优于Ⅲ组,差异有统计学意义（P〈0.05）。治疗8周后,Ⅰ组有效率明显优于Ⅱ组、Ⅲ组,差异有统计学意义（P〈0.05）。治疗12周后,Ⅰ组平均血红蛋白浓度均明显高于Ⅲ组,差异有统计学意义（P〈0.05）。结论婴幼儿佝偻病治疗初期应选用大剂量维生素D3联合铁锌钙治疗效果更佳,且长期铁锌钙合剂治疗不会造成血红蛋白浓度下降,宜作为婴幼儿佝偻病的首选治疗方法。

Clinical Comparative Analysis of Vitamin D Combined with Different Calcium Agents in Treatment of Infantile Rachitis

Objective To compare the clinical efficacy of different formulations of vitamin D and pure calcium or iron,zinc and calcium mixture combined treatment to infantile rachitis. Methods One hundred and seventy-five patients with vitamin D deficiency rachitis were divided into large-dose vitamin D3 combined iron,zinc and calcium mixture in the treatment group for 72 cases(I),large-dose vitamin D3 combined calcium in the treatment group for 68 cases(II) and small-dose vitamin D2 combined calcium in the treatment group for 35 cases(III).Take three groups of patients treated after 4 weeks,8 weeks for the comparative analysis of efficacy.Compare the variation of hemoglobin concentration of three groups treated after 8 weeks. Results After 4 weeks of treatment,there was no statistically significant difference in the treatment efficiency compared group Ⅰwith Ⅱ(P>0.05).The efficiency of treatment in group Ⅰwas obviously better than in group Ⅲ compared group Ⅰwith Ⅲ,and the difference was statistically significant(P<0.05).After 8 weeks of treatment,the efficiency of treatment in group Ⅰwas obviously better than in group II and III,and the difference was statistically significant(P<0.05).After 12 weeks of treatment,the average hemoglobin concentration in group Ⅰwas obviously higher than in group Ⅲ,and the difference was statistically significant(P<0.05). Conclusions During the early treatment of infantile rachitis,choosing large-dose vitamin D3 combined iron,zinc and calcium mixture therapy is more effective, and the iron,zinc and calcium mixture won’t cause hemoglobin concentration decreased,so it should be the first choice for infantile rachitis as therapy.