文章摘要

阿法骨化醇在预防早产儿佝偻病中的应用

作者: 1张桂玲, 2卢青军, 1任文娟, 3杨娅丽, 1赵会娟, 1张怀强, 1张克勤, 1李婷婷, 4贾茹茹
1 中国人民解放军陆军第八十一集团军医院儿科,河北 张家口 075000
2 中国人民解放军陆军第八十一集团军医院烧伤整形外科,河北 张家口 075000
3 张家口市妇幼保健院新生儿科,河北 张家口 075000
4 张家口市崇礼区人民医院妇产科,河北 张家口 076350
通讯: 张桂玲 Email: zglx251@163.com
DOI: 10.3978/j.issn.2095-6959.2020.09.025
基金: 张家口市重点研发计划项目(1921110D)。

摘要

目的:探究阿法骨化醇在早产儿佝偻病中的应用价值。方法:本研究选取2017年1月至2020年1月在新生儿监护病房中出院的早产儿为研究对象,随机均分为对照组与研究组,对照组给予维生素D口服,研究组给予阿法骨化醇治疗。比较两组治疗总有效率及临床症状发生率;比较两组治疗前后25-(OH)D3、血磷、血钙水平、骨代谢指标[骨源性碱性磷酸酶(bone alkaline phosphatase,BALP)、碱性磷酸酶(alkaline phosphatase,ALP)、骨钙素]及桡骨、尺骨骨密度;统计两组患者维生素D异常及佝偻病发生情况;观察两组患者治疗期间不良反应发生情况。结果:研究组治疗总有效率高于对照组,临床症状总发生率低于对照组(P<0.05);研究组治疗后25-(OH)D3、血磷、血钙水平高于对照组(P<0.05);研究组治疗后ALP、骨钙素水平高于对照组,BALP水平低于对照组(P<0.05);研究组治疗后桡骨、尺骨骨密度高于对照组(P<0.05);研究组佝偻病发生率低于对照组(P<0.05);两组患者均未出现明显不良反应。结论:阿法骨化醇可促进早产儿钙磷吸收,改善骨代谢,降低佝偻病发生率。
关键词: 阿法骨化醇;早产儿;佝偻病;应用价值

Application of alfacalcidol in preventing rickets of premature infants

Authors: 1ZHANG Guiling, 2LU Qingjun, 1REN Wenjuan, 3YANG Yali, 1ZHAO Huijuan, 1ZHANG Huaiqiang, 1ZHANG Keqin, 1LI Tingting, 4JIA Ruru
1 Department of Pediatric, The 81th Group Army Hospital of Chinese People’s Liberation Army, Zhangjiakou Hebei 075000, China
2 Department of Burn and Plastic Surgery, The 81th Group Army Hospital of Chinese People’s Liberation Army, Zhangjiakou Hebei 075000, China
3 Department of Neonatology, Maternal and Child Health Hospital in Zhangjiakou, Zhangjiakou Hebei 075000, China
4 Department of Obstetrics and Gynecology, People’s Hospital in Chongli District, Zhangjiakou Hebei 076350, China

CorrespondingAuthor: ZHANG Guiling Email: zglx251@163.com

Foundation: This work was supported by the Key Research & Development Project of Zhangjiakou, China (1921110D).

Abstract

Objective: To explore the application value of alfacalcidol in rickets of premature infants. Methods: In this study, premature infants who were discharged from the neonatal intensive care unit (NICU) during the period from January 2017 to January 2020 were enrolled as the research objects. They were randomly divided into control group and study group. The control group was given oral vitamin D, while study group was given alfacalcidol. The total response rate of treatment and incidence of clinical symptoms, levels of 25-(OH)D3, blood phosphorus and blood calcium, bone metabolism indexes [bone alkaline phosphatase (BALP), alkaline phosphate (ALP), osteocalcin], bone density of radius and ulna before and after treatment were compared between the 2 groups. The occurrence of vitamin D abnormalities and rickets in both groups was statistically analyzed. The occurrence of adverse reactions during treatment in both groups was observed. Results: The total response rate of treatment was higher in study group than control group, while total incidence of clinical symptoms was lower in study group (P<0.05). After treatment, levels of 25-(OH)D3, blood phosphorus and blood calcium were higher in study group than control group (P<0.05), levels of ALP and osteocalcin were higher in study group, and BALP level was lower in study group (P<0.05). After treatment, bone density of radius and ulna was higher in study group than control group (P<0.05). The incidence of rickets was lower in study group than control group (P<0.05). There were no significant adverse reactions in either group. Conclusion: The response rate of alfacalcidol is high in preventing rickets of premature infants. It can promote calcium-phosphorus absorption, improve bone metabolism, and reduce the incidence of rickets.
Keywords: alfacalcidol; premature infant; rickets; application value